应用胶囊内镜诊断不明原因消化道出血病例分析

Application of capsule endoscopy in diagnosis of obscure gastrointestinal bleeding

回顾性分析83例不明原因消化道出血（OGIB）患者进行胶囊内镜检查的临床资料。结果显示，阳性病变总检出率为81．9％（68／83），小肠病变检出率为77．1％（64／83），其中以血管动静脉畸形（AVM）最为常见（22例，占26．5％），其次为小肠占位18例（21．7％）和小肠黏膜单发或多发溃疡16例（19．3％），4例（4．8％）患者的出血部位位于小肠以外。〉50岁患者以小肠AVM为最主要病因，小肠占位主要见于30-50岁患者，〈30岁患者则以小肠溃疡最多见。所有患者检查中和检查后均未出现并发症。提示，胶囊内镜检查诊断OGIB的价值较高。OGIB以小肠AVM最多见，其次为小肠占位和小肠溃疡。不同年龄OGIB组间病因比较差异有统计学意义。

Clinical data of 83 patients with obscure gastrointestinal bleeding （ OGIB ） undergoing capsule endoscopy were reviewed retrospectively. The results showed that the overall detection rate of gastrointestinal lesions for OGIB by capsule endoscopy was 81.9% （68/83）, most lesions （77.1%, 64/83 ） were located in small intestine. Of all the small intestinal lesions, arteriovenous malformation （ AVM ） was the most common （22 cases, 26. 5% ）, followed by small intestinal space-occupying lesion （18 cases, 21.7% ） and single or multiple ulcers of small intestine （ 16 cases, 19. 3% ）. Four cases （4. 8% ） had lesions outside of the small intestine. Small intestinal AVM was the leading cause of OGIB in patients 〉 50 y, space-occupying lesion was the most common in patients aged 30 - 50 y, while ulcer was the leading cause in patients 〈 30 y. Bowel obstruction was not found in this group of patients. The results indicate that capsule endoscopy has great diagnostic value in detecting causes of OGIB. Small intestinal AVM is the most common cause of OGIB, followed by space-occupying lesion and ulcer.