胶囊内镜全小肠检查的研究进展

Advances in complete small-bowel examination by capsule endoscopy

胶囊内镜的电池工作时间一般为8h左右,大部分胶囊内镜在工作时间内能够完成全小肠检查,但还有10%-30%胶囊内镜在这一时间由于机械性梗阻以外的因素而无法到达回盲瓣.小肠检查不完全导致远端小肠病变漏诊的风险.目前研究表明,糖尿病可导致胃轻瘫、增加胃通过时间,有腹部手术史的患者肠道通过时间延长,二者均降低完成率.使用泻药进行肠道准备可提高胶囊内镜的诊断率和小肠成像质量,但对胃肠道通过时间和完成率并无差异.尝试用于提高完成率的研究包括促动力药、实时干预调频、右侧卧位、咀嚼口香糖等.今后的研究应在提高完成率的同时着眼于提高诊断率,并明确高危人群的最佳干预组合方式.

Capsule endoscopy（CE） has a battery life of 8 h,during which time complete small-bowel exami-nation can be achieved in most cases.However,in 10-30%of cases,the capsule cannot reach the ileocecal valve before the end of the life of the capsule＇s battery due to factors other than me-chanical bowel obstruction.Incomplete exami-nation of the entire small bowel leaves room for missing lesions.Some studies have shown that diabetes mellitus can lead to gastroparesis and increase gastric transit time（GTT）,while history of abdominal surgery can increase small bowel transit time（SBTT）.Therefore,these two factors can decrease the rate of complete small-bowel examination by CE.Purgative bowel cleansing can improve the detectability and image qual-ity of CE,but has no significant impact on GTT,SBTT and CR.Prokinetic drugs,real-time CE,right lateral position,and chewing-gum are all under research for increasing CR.In future stud-ies,emphasis should be placed in improving the diagnostic ability of CR and ensuring optimal intervention for patients with high risk factors for incomplete small-bowel examination.