胶囊内镜对小肠钩虫病的诊断价值分析

Value of capsule endoscopy for diagnosis of intestinal hookworm disease

目的探讨胶囊内镜在小肠钩虫病诊断中的价值。方法回顾分析昆明医科大学第一附属医院2010年8月至2015年12月通过胶囊内镜诊断的10例小肠钩虫病患者的临床资料,对其临床症状、实验室检查和影像学检查、胶囊内镜图像进行分析。结果 6例患者以腹痛为主要临床表现,2例患者解暗红色血便,1例黑便,1例患者以纳差消瘦为主要临床表现。4例患者外周血嗜酸性粒细胞百分比升高,4例患者大便潜血阳性,均未检出虫卵。所有患者通过胃镜、肠镜、腹部B超、CT、口服法小肠造影均未检出钩虫。10例均经胶囊内镜确诊为钩虫感染,其中,5例患者虫体寄生于空肠,5例患者空肠及回肠均有寄生。结论胶囊内镜诊断小肠钩虫病准确率高,除不明原因的消化道出血外,胶囊内镜检查对钩虫病引起的腹痛、腹部不适等症状,亦有其独到的诊断价值,且可对钩虫在小肠内的分布情况及生活习性的观察提供参考。

Objective To investigate the value of capsule endoscopy in the diagnosis of intestinal hookworm disease.Methods Retrospective analysis was performed on the clinical data of 10 patients with intestinal hookworm disease diagnosed by capsule endoscopy in the First Affiliated Hospital of Kunming Medical University between August 2010 and December 2015. Results Abdominal pain as the main clinical manifestation was seen in 6 cases; dark red blood stool was seen in 2 cases; black stool was seen in 1 case; anorexia and weight loss as the main clinical manifestation was seen in1 case. The percentage of eosinophile granulocyte in peripheral blood increased in 4 cases; positive fecal occult blood was seen in 4 cases; Hookworm egg was not found in all cases. Hookworm was not found in all patients who received gastroscopy,electronic colonoscopy,abdominal ultrasonography,CT,and oral enterography. Hookworm infection was diagnosed by capsule endoscopy in 10 cases in whom the polypide parasitized on jejunum in 5 cases and on both jejunum and ileum in 5cases. Conclusion Capsule endoscopy has a higher accuracy rate for the diagnosis of intestinal hookworm disease. In addition to gastrointestinal bleeding unknown causes,capsule endoscopy has a unique diagnostic value for the symptoms caused by hookworm disease such as abdominal pain and uncomfortable,and can also provide a basis for the the observation of distribution situation of hookworm in small intestine and its living behavior.