胶囊内镜滞留小肠原因及处理的国内文献回顾与分析

Capsule endoscope retention in small bowel: review of domestic literature

目的探讨胶囊内镜滞留小肠的原因及处理方式。方法回顾性分析2001年-2013年国内有关胶囊内镜滞留小肠的191篇中文文献,分析其滞留原因及处理方式。结果在105例胶囊内镜滞留小肠患者中,滞留原因主要为克罗恩病(CD)(54.3%,57/105),其次是小肠肿瘤(21.9%,23/105)。57.9%(33/57)的CD患者需行手术干预,24.6%(14/57)的CD患者可保守治疗后排出,仅3.5%(2/57)可自行排出。56.5%(13/23)的小肠肿瘤患者需行手术治疗,只有8.7%(2/23)可自行排出。所有滞留患者中,45.7%(48/105)需手术干预,2.9%(3/105)行内镜干预,保守治疗和自行排出者为22.8%(24/105)。结论胶囊内镜滞留小肠是胶囊内镜检查中较严重的并发症,引起滞留的主要原因是CD和小肠肿瘤,多数滞留者需手术干预。

Objective To analyze the cause and management of capsule endoscope retention in small bowel. Meth-ods A retrospective analysis of the data of 105 cases with capsule endoscope retention in small bowel was performed from 191 papers published in Chinese literature from 2001 to 2013. Results Among the 105 cases, 54. 3% patients caused by Crohn’ s disease （ CD） and 21. 9% patients caused by neoplasm in small bowel. Of 57 cases with CD, 57. 9% patients were removed the capsule by operative intervention, 24. 6% by medical treatment and only 3. 5% by spontaneous resolution. Of 23 cases with small bowel neoplasm, 56. 5% patients were performed by operative interven-tion and only 8. 7% by spontaneous resolution. All of 105 retained cases, 45. 7% was performed by operation, 2. 9%by endoscope and 22. 8% by medical and spontaneous resolution. Conclusion Capsule endoscope retention is a rare and serious complication in the examination of capsule endoscopy. CD and small bowel neoplasm are the leading cause, and most cases need operative intervention.