胶囊内镜胃通过时间与全小肠检查完成率的关系

Relationship between gastric transit time and complete examination rate of the capsule endoscopy examinations

目的:探讨对胶囊内镜在胃内停留时间较长的患者进行干预的恰当时机.方法:分析了109例胶囊内镜检查的胃通过时间(gastric transit time,GTT)与全小肠检查完成率(complete examination rate,CER)的关系,GTT与小肠通过时间(small bowel transit time,SBTT)的相关性,完成与未完成全小肠检查者GTT的差异,小肠肠腔狭窄者完不成全小肠检查的风险.结果:胶囊GTT分别为≤30min,30-60min,60-90min,>90min的各组之间的CER无统计学差异(P=0.971);胶囊胃内停留时间过长者注射胃复安后,其SBTT明显短于非胃复安组(t=-2.027,P=0.046);完成全小肠检查者的GTT(45.6min±35.8min,n=85)与未完成者的GTT(42.0min±36.4min,n=24)之间无统计学差异(P=0.665);小肠肠腔狭窄者未完成全小肠检查的风险是无狭窄者的6.588倍(OR=6.588,95%CI=1.866-23.258,P=0.004).结论:过早使用胃镜将胶囊送入小肠可能并不一定有助于CER的提高,胶囊在胃内停留超过90min的要考虑用胃镜将胶囊送入小肠,整个送胶囊过程最好在30min之内完成.

AIM： To investigate the right timing for inter- vention when capsule endoscope transits for a relatively long time in the stomach. METHODS： The following items were analyzed in 109 patients who underwent capsule endoscopy （CE） examinations： the relationship between gas- tric transit time （GTT） and complete examination rate （CER）; the correlation between GTT and small bowel transit time （SBTT）; the difference in GTT between groups of complete and incomplete exami- nations; and the risk of incomplete examination in patients with strictures of the small intestine. RESULTS： No difference was found in CER among groups with GTT ≤ 30 min, 30-60 min, 60-90 min, or 〉 90 min （P = 0.971）. Injection of metoclopramide in patients with longer GTT re-sulted in shorter SBTT compared to their counter- parts with shorter GTT （t = -2.027, P = 0.046）. No difference was found in GTT between groups of complete and incomplete examinations [45.6 min ± 35.8 min （n = 85） vs 42.0 min ± 36.4 min （n = 24）, P= 0.665]. The risk of incomplete examination in patients with strictures of the small intestine was 6.588-fold higher than those without strictures （OR = 6.588, 95% CI = 1.866-23.258, P = 0.004）. CONCLUSION： Too early delivery of capsule endoscope in the duodenum might not improve CER. This procedure should be considered only if the retention of CE in the stomach exceeds 90 min, and it is better to be completed within 30 min.