胶囊内镜未完成全小肠检查的危险因素分析

Analysis of risk factors for incomplete whole small intestine examination by capsule endoscopy

目的探讨小肠胶囊内镜检查未完成的临床特点及其危险因素。方法回顾性分析2015年8月至2019年2月于徐州医科大学附属医院行胶囊内镜小肠检查282例患者资料,统计其临床及实验室检查资料,通过多因素逻辑回归分析患者未完成全小肠检查的危险因素。结果在所有282例患者中,未完成检查者有45例,未完成率为16.0%(45/282)。多因素分析显示男性(OR=3.261,95%CI 1.084~9.815,P=0.035)、年龄(64.78±13.23)岁(OR=1.046,95%CI 1.007~1.086,P=0.020)、胃内时间[59.78(27.89,108.67)]min(OR=1.014,95%CI 1.005~1.024,P=0.004)、消化道出血(OR=3.017,95%CI 1.025~8.880,P=0.045)、腹部手术史(OR=4.902,95%CI 1.553~15.470,P=0.007)是检查未完成的危险因素;血红蛋白(95.20±26.16)g/L(OR=0.977,95%CI 0.957~0.998,P=0.033)、白蛋白(35.73±7.11)g/L(OR=0.871,95%CI 0.790~0.961,P=0.006)是检查未完成的保护因素。结论男性、年龄、胃内时间、消化道出血、腹部手术史是胶囊内镜小肠检查未完成的危险因素,血红蛋白、白蛋白是其保护因素。患者在行胶囊内镜检查前,除评估肠道狭窄情况外,也需关注患者的营养状况及临床症状,提高患者的检查完成率。

Objective To explore the clinical characteristics and risk factors of incomplete endoscopy of small intestine capsule.Methods From August 2015 to February 2019,the data of 282 patients with small intestine examination by capsule endoscopy in Affiliated Hospital of Xuzhou Medical University were analyzed retrospectively.The clinical and laboratory examination data were statistically analyzed.The risk factors of incomplete small intestine examination were analyzed by multivariate logistic regression.Results In all 282 patients,45 cases did not complete the examination,the incomplete rate was 16.0%(45/282).Multivariate analysis showed that male(OR=3.261,95%CI1.084-9.815,P=0.035),age(64.78±13.23)years(OR=1.046,95%CI1.007-1.086,P=0.020),intragastric time(59.78(27.89,108.67))min(OR=1.014,95%CI1.005-1.024,P=0.004),gastrointestinal bleeding(OR=3.017,95%CI1.025-8.880,P=0.045),abdominal operation history(OR=4.902,95%CI1.553-15.470,P=0.007)were risk factors for incomplete examination.Hemoglobin(95.20±26.16)g/L(OR=0.977,95%CI0.957-0.998,P=0.033),albumin(35.73±7.11)g/L(OR=0.871,95%CI0.790-0.961,P=0.006)were protective factors for incomplete examination.Conclusion Male,age,intragastric time,gastrointestinal hemorrhage and abdominal operation history were risk factors for incomplete small bowel examination with capsule endoscopy,and hemoglobin and albumin were protective factors.Before capsule endoscopy,patients should not only evaluate the intestinal stenosis,but also pay attention to the nutritional status and clinical symptoms of patients,so as to improve the completion rate of patients.