不同年龄组不明原因消化道出血患者胶囊内镜诊断价值分析

Diagnostic value analysis of capsule endoscopy in obscure gastrointestinal bleeding patients of different ages

目的探讨胶囊内镜对不同年龄组不明原因消化道出血（OGIB）患者的诊断价值，观察其有效性和安全性。方法选取2005年3月至2016年3月北京协和医院消化内科收治的216例OGIB患者为研究对象。按年龄分为青年组、中年组和老年组。对各年龄组患者人口学特征、临床表现、胶囊内镜工作情况及胶囊内镜检查结果进行回顾性统计分析。结果青年组与中年组的病变检出率和诊断率是：98．53％比98．51％（P=0．992），92．65％比91．04％（P=0．734），青年组与老年组的病变检出率和诊断率是：98．53％比91．14％（P=0．109），92．65％比87．34％（P=0．289），中年组和老年组的检出率和诊断率是：98．51％比91．14％（P=0．113），91．04％比87．34（P=0．475）。各组差异无统计学意义。各年龄组小肠病变的分布不尽相同。青年组以血管畸形、小肠溃疡和克罗恩病多见；中年组前三位病变分别是血管畸形、非特异性小肠炎症和小肠溃疡；老年组以血管畸形、小肠溃疡和小肠黏膜糜烂多见。结论对于各年龄组OGIB患者，胶囊内镜均是安全、有效、舒适的检查手段，可广泛应用于临床。

Objective To evaluate the diagnostic value of capsular endoscopy in patients with obscure gastrointestinal bleeding （OGIB） in different age groups, and assess its effectiveness and safety. Methods A total of 216 patients who were diagnosed with OGIB between March 2005 and March 2016 at Department of Gastroenterology of Peking Union Medical College Hospital were retrospectively reviewed. They were assigned into three groups： young adults, middle-aged and elderly. The demographic characteristics, clinical manifestations, working performance as well as endoscopic features in each group were collected and analyzed. Results The detection rate and diagnosis rate of the young adults and middle-aged group were 98.53% vs 98.51% （P =0. 992）, 92. 65% vs 91.04% （P =0. 734） , while those between the young adults and the elderly group were 98.53% vs 91.14% （P = 0. 109）, 92. 65% vs 87. 34% （P=0.289）, and 98.51% vs 91.14% （P=0.113） and 91.04% vs 87.34 （P=0.475） between the middle-aged and elderly group. No significant difference existed in either detection rates nor diagnostic rates between the different age groups. The distribution of the small intestinal lesions varied between the different age groups. The top three common lesions in young adults were vascular malformation, small intestine ulcer and Crohn＇s disease, while in the middle-aged group vascular malformation, non-specific enteritis and small intestine ulcer were the most common. Patients in elderly group were most likely to have vascular malformation, small intestine ulcer and erosion. Conclusions For patients of any age with OGIB, capsule endoscopy is a safe, effective and comfortable examination which can be widely used in clinical practice.