胶囊内镜在不同小肠疾病诊断中的应用价值

The value of capsule endoscopy in diagnosing different small bowel diseases

目的探讨胶囊内镜在不同小肠疾病诊断中的应用价值。方法 42例患者进行胶囊内镜检查,其中不明原因消化道出血25例、慢性腹痛6例、慢性腹泻7例、慢性腹痛伴腹泻3例、体检1例,观察运行时间及病变检出率。结果 42例患者中33例(78.57%)通过回盲瓣,2例胶囊内镜滞留于胃内。胶囊内镜胃内平均停留时间为77.5 m in,经过小肠平均时间为286.5 m in。病变总检出率为76.19%,其中不明原因消化道出血88%、慢性腹痛83.3%、慢性腹泻42.8%、慢性腹痛伴腹泻66.7%。不明原因消化道出血的病变检出率明显高于慢性腹泻(P<0.05)。检查过程中患者无不适及并发症。结论胶囊内镜对小肠病变的检出率较高,且安全、方便,可作为小肠疾病的首选检查方法,尤其可作为不明原因消化道出血患者的常规检查。

Objective To discuss the value of capsule endoscopy in diagnosing different small bowel diseases.Methods Forty-two cases accepted capsule endoscopy examination.Among the 42 patients,there were 25 cases of obscure gastrointestinal bleeding,6 cases of chronic abdominal pain,7 cases of chronic diarrhea,3 cases of chronic abdominal pain concomitant diarrhea,and 1 case of physical examination.Gastric and small bowel transit time and diagnostic yield were valuated.Results Thirty-three cases crossed over the ileocecal valves,and 2 cases retarded in gastric.The capsule endoscopy remained in the stomach for an average of 77.5 min.The mean transit time in the small bowel was 286.5 min.The total detectablerate of capsule endoscopy was 76.19%.The detectablerate of obscure gastrointestinal bleeding was 88%,chronic abdominal pain was 83.3%,chronic diarrhea was 42.8%,and chronic abdominal pain concomitant diarrhea was 66.7%.The detectablerate of obscure gastrointestinal bleeding was significantly higher than chronic diarrhea.All the patients had no discomfortable feeling and complication during the examination.Conclusion The detectablerate of capsule endoscopy of small bowel diseases is high.Capsule endoscopy is safe and convenient.So capsule endoscopy can become the first examination technique in small bowel diseases,especially obscure gastrointestinal bleeding.