胶囊内镜在325例疑似小肠疾病中的诊断价值

Diagnostic value of capsule endoscopy in 325 cases of suspected small bowel disease

目的分析胶囊内镜在小肠疾病诊断中的应用价值。方法选取2004年6月—2015年10月上海同济大学附属东方医院消化内科325例疑似小肠疾病的患者(症状组),经胃肠镜检查、腹部CT、钡剂造影等检查均未能明确诊断,采用以色列PillCam胶囊内镜或韩国MiroCam胶囊内镜检查,并以53例健康体检者(体检组)作为对比,对其临床资料进行分析。结果老年人多以不明原因消化道出血(OGIB)和贫血接受检查,中青年则以腹痛、腹泻等症状为主。325例中有318例顺利完成检查,成功率为97.8%;完成全小肠检查288例,成功率为88.6%。其中186例发现小肠病变,病变检出率为57.2%;169例患者明确小肠疾病的病因,诊断率为52.0%。所检出的疾病包括克罗恩病、血管畸形、糜烂、溃疡、息肉、憩室、肿瘤、吸收不良等。53例无症状体检者全部完成检查,发现小肠病变13例,病变检出率为24.5%,6例明确病因,诊断率为11.3%。结论胶囊内镜全小肠检查成功率高,对疑似小肠疾病者有较高的诊断价值,对无症状体检者也有较好的筛查价值,尤其对老年人安全、耐受性好,值得推广。

Objective To analyze value of capsule endoscopy in the diagnosis of small intestinal diseases.Methods An retrospective analysis was made on Israel PillCam capsule endoscopy or Korea MiroCam capsule endoscopy examination for 325 patients with suspected small bowel disease from March 2004 to October 2015,and compared with 53 healthy subjects. Results Elderly people with unknown causes of gastrointestinal bleeding （ OGIB） and anemia were examined, in the young people with abdominal pain, diarrhea and other symptoms.In 325 cases, 318 cases were successfully completed, the success rate was 97.8%, the total small bowel examination was completed in 288 cases, and the success rate was 88.6%.Among them, 186 cases were found small bowel lesions;the detection rate was 57.2%.169 patients were diagnosed as the cause of the disease;the diagnosis rate was 52.0%.The detection of diseases including Crohn＇s disease, vascular malformation, ero-sion, ulcer, polyp, diverticulum, tumor, malabsorption, etc.53 cases of asymptomatic physical examination were completed and found 13 cases of small intestinal lesions, the detection rate was 24.5%, 6 cases of clear cause, the diagnosis rate was 11.3%.Conclusion Capsule endoscopy small bowel examination with high success rate, has high value in the diagnosis of suspected small intestinal diseases, also has good value of screening for asymptomatic persons, particularly for the elderly is safe and well tolerated, worthy of promotion.