胶囊内镜滞留肠道的危险因素分析及预后随访

The risk factors and prognosis of capsule retentions of capsule endoscopy examinations

目的：探讨胶囊内镜发生肠道滞留的危险因素、应对的处理方式和预后随访。方法选择2006年10月至2013年3月间行 OMOM胶囊内镜检查的患者1100例，记录胶囊内镜对小肠病变的阳性发现，胶囊内镜发生肠道滞留者的检查适应证、胶囊内镜检查结果、处理方式及预后随访。结果在1100例胶囊内镜检查中，共13例（1．18％）发生胶囊滞留，其中不明原因消化道出血（OGIB）患者4例（占0．95％），疑诊克罗恩病患者4例（占4．0％），确诊克罗恩病患者2例（占10．5％），疑诊小肠肿瘤患者2例（占7．1％），慢性腹痛患者1例（占0．3％）。11例患者经口小肠镜取出胶囊，1例经外科手术取出胶囊，另 1例经内科治疗1年后胶囊自行排出体外。确诊或疑诊克罗恩病为发生胶囊滞留的高危因素（OR ＝11．44，P ＝0．02；OR ＝5．59，P ＝0．02），疑诊小肠肿瘤亦为胶囊滞留的高危因素（OR ＝7．42，P ＝0．04）。结论胶囊内镜肠道滞留的发生率低（1．18％），但对于具有胶囊滞留高危因素者，胶囊内镜检查前仍需权衡利弊。

Objective To evaluate the risk factors,treatment and follow-up of capsule retentions after capsule endoscopy examination.Methods A total of 1 100 capsule enteroscopic examinations,performed at our hospital from October 2006 to March 2013,were retrospectively studied.The positive findings of lesions, clinical indications of capsule endoscopy,treatment and follow-ups were recorded.Results The incidence of capsule retentions was 1.18%（n =13）.The rates of capsule retentions in OGIB,suspected Crohn′s disease （CD）,known CD,suspected tumors and chronic abdominal pain were 0.95%,4.0%,10.5%,7.1% and 0.3%,respectively.In 11 patients,the capsule was removed by means of double-balloon enteroscopy,the cap-sule was removed surgically in one patient,and spontaneous expulsion occurred in another patient after 1 year of treatment.Risk factors for capsule retention were known or suspected CD and suspected tumor（OR =11.44, P =0.02;OR =5.59,P =0.02）,and suspected tumor was also a risk factor（OR =7.42,P =0.04）.Conclu-sion Capsule endoscopy is a safe procedure with low risk of capsule retentions.Advantages and disadvantages of capsule endoscopy examinations should be considered carefully when high-risk patients are involved.