CE与小肠结肠双期增强CT对不明原因消化道出血诊断价值的评价

Evaluation of diagnosis value by capsule endoscopy and dual phase enhanced CT of small intestine and colon for obscure gastrointestinal bleeding

目的分析不明原因消化道出血(OGIB)的病因,比较CE(CE)与小肠结肠双期增强CT对OGIB的诊断价值及优势。方法临床诊断考虑为OGIB的患者101例,分别行CE及小肠结肠双期增强CT检查,计算CE及小肠结肠双期增强CT对不同病变的检出率,比较其差异。结果 101例行CE检查患者共发现病变77例,其中小肠病变69例,小肠外病变8例。小肠结肠双期增强CT发现病变25例,其中小肠病变15例,小肠外病变10例。两种方法的出血相关小肠病变检出率比较,差异有统计学意义(P<0.05)。结论 CE是对OGIB的有效检查方法 ,其病变检出率明显高于小肠结肠双期增强CT,临床上对于OGIB患者采用CT联合CE的检查方法可提高疾病的检出率并指导手术治疗。

Objective To analyze pathogenesis of obscure gastrointestinal bleeding（OGIB）, and to compare diagnosis value and advantages of capsule endoscopy（CE） and dual phase enhanced CT of small intestine and colon for OGIB. Methods A total of 101 clinically diagnosed OGIB patients received CE and dual phase enhanced CT of small intestine and colon respectively. Detection rates for different lesions by CE and dual phase enhanced CT of small intestine and colon were calculated for comparison. Results Among 101 patients receiving CE, there were 77 cases with lesions. There were 69 cases with small intestine lesion and 8 cases with lesion outside small intestine. Dual phase enhanced CT of small intestine and colon showed 25 lesion cases. There were 15 cases with small intestine lesion and 10 cases with lesion outside small intestine. The difference of detection rate of hemorrhage-related small intestine lesion between the two methods had statistical significance（P〈0.05）. Conclusion CE is an effective diagnosis method for OGIB, and it provides much higher detection rate than dual phase enhanced CT of small intestine and colon. Implement of CT combined with CE for OGIB patients can improve detection rate and provide guidance for surgical treatment.