胶囊内镜诊断小肠克罗恩病的价值

Diagnostic value of capsule endoscopy for the diagnosis of small bowel Crohn's diseases

目的探讨胶囊内镜(capsule endoscope,CE)在小肠克罗恩病(Crohn’disease,CD)诊断中价值。方法回顾性分析2009年9月至2014年5月期间已确立结肠CD诊断(established CD,e CD)的20例患者和疑诊小肠CD(sus-pected CD,s CD)的21例患者的胶囊检查资料。结果 eCD组13例发现小肠CD病变,sCD组10例诊断小肠CD,所有诊断小肠CD的23例患者中12例表现为糜烂/浅溃疡、11例深溃疡,7例溃疡合并狭窄,5例溃疡合并出血,4例溃疡伴结节样改变;病变位于在空肠3例(13.0%),空及回肠16例(69.6%),只在回肠4例(17.4%)。回盲瓣通过率70.7%(29/41),3例胶囊无症状滞留,1例肠镜下取出,另外2例分别在26 d和53 d排出。结论在eCD和sCD患者中,胶囊内镜可作为小肠CD安全有效的检查手段,对判定小肠CD黏膜损害的程度、范围有较高的诊断价值。

Objective To investigate the value of capsule endoscope（CE） for the diagnosis of small bowel Crohn＇s disease（CD）. Methods The clinical data of 20 patients with established colon CD（e CD） and 21 paitents with suspected CD（s CD） who underwent CE between September 2009 and March 2014 were retrospectively analyzed. Results Thirteen of 20 patients with e CD and 10 of 21 patients with s CD had small bowel CD mucosal lesions under CE. Twelve were erosions or superficial ulcers, 11 were deep ulcers,7 were ulcerated strictures,5 were ulcers combined with bleeding and 4nodular lesions were observed in 23 small bowel CD. Thirteen percent（3/23） lesions occurred only in jejunum, 69.6%（16/23）in jejunum and ileum, 17.4%（4/23）only in ileum. The inspection success rate was 70.7%. Asymptomatic capsule retention was observed in 3 patients. One case was successfully retrieved by colonoscopy. The capsule was excreted in 26 days and 53 days in two cases. Conclusion CE is a safe and effective inspection method in e CD and s CD. It has high diagnostic value for determining the degree and scope of small bowel CD mucosal lesion.