胶囊内镜联合多层螺旋CT对不明原因消化道出血诊断效率的临床研究

Clinical study of capsule endoscopy combined with multi-slice spiral CT in the diagnosis of unexplained gastrointestinal hemorrhage

目的比较胶囊内镜(CE)、多层螺旋CT(MSCT)及两种检测手段联用对不明原因的消化道出血(OGIB)检测和诊断效率的差异。方法纳入2017年1月至2018年8月经重庆市人民医院三院消化内科及重庆市西南医院影像科接受检查的患者,同时符合入选标准并不符合排除标准,按照年龄和出血方式对其进行分组,对患者行CE和MSCT检查,比较两种检查方式的病变检出率、病因诊断率及检测、诊断的一致性。结果 CE的病变检出率和病因诊断率均显著高于MSCT(P <0. 05),CE联合MSCT病变检出率和病因诊断率显著高于CE和MSCT(P <0. 05)。在显性出血组,CE的病变检出率和病因诊断率显著高于MSCT(P <0. 05),CE联合MSCT病变检出率显著高于MSCT (P <0. 05)。隐性出血组中,CE与MSCT的病变检出率和病因诊断率间无显著性差异(P> 0. 05),CE联合MSCT的病变检出率和病因诊断率显著高于CE和MSCT(P <0. 05)。青年组中CE的病变检出率和病因诊断率均显著高于MSCT(P <0. 05),CE联合MSCT的病变检出率和病因诊断率均显著高于MSCT(P <0. 05),与CE间无显著差异(P> 0. 05)。在中老年组中,CE的病变检出率和病因诊断率与MSCT间无显著差异(P> 0. 05),CE联合MSCT的病变检出率和病因诊断率均显著高于CE和MSCT(P <0. 05)。结论 CE、MSCT均为安全、有效的OGIB检测手段,CE对于OGIB的病变检测率和病因诊断率均显著高于MSCT,尤其在显性出血组和青年人群中。两者联合应用检测效率显著高于CE和MSCT,但在青年人群中,两者联合使用检测效率与单独使用CE无显著差异。

Objective To compare the differences in the detection and diagnosis efficiency of OGIB between CE,MSCT and two detection methods. Methods Patients who underwent examinations in our hospital from January 2017 to August 2018,who met the inclusion criteria and did not meet the exclusion criteria,were grouped according to age and bleed pattern. CE examinations were performed on patients.MSCT examination,comparing the detection rate of the two types of examination,the cause of the diagnosis of the disease and the consistency of detection and diagnosis. Results The detection rate and etiology of CE were significantly higher than those of MSCT( P < 0. 05). The detection rate and etiology of CE combined with MSCT were significantly higher than CE and MSCT( P < 0. 05). In the dominant bleeding group,CE lesion detection rate and etiological diagnosis rate were significantly higher than MSCT( P < 0. 05),CE detection and MSCT lesion detection rate and etiological diagnosis rate were significantly higher than CE and MSCT( P < 0. 05). In the recessive hemorrhage group,there was no significant difference between the detection rate of CE and MSCT and the cause of diagnosis( P > 0. 05). The detection rate and etiology of CE and MSCT were significantly higher than CE and MSCT( P < 0. 05). The detection rate and etiological diagnosis rate of CE in the young group were significantly higher than those of MSCT( P < 0. 05). The detection rate and etiological diagnosis rate of CE combined with MSCT were significantly higher than those of MSCT( P < 0. 05). There was no significant difference( P > 0. 05). In the middle-aged group,there was no significant difference between CE detection and etiological diagnosis rate and MSCT( P > 0. 05). The detection rate and etiological diagnosis rate of CE combined with MSCT were significantly higher than CE and MSCT( P < 0. 05). Conclusions CE and MSCT are safe and effective OGIB detection methods. The detection rate and etiological diagnosis rate of CE for OGIB are significantly higher than those of MSCT,especially in the dominant bleeding group and the young population. The combined detection efficiency of the two was significantly higher than that of CE and MSCT,but in the young population,the combined detection efficiency of the two was not significantly different from the CE alone.