胶囊内镜胃内滞留112例的处理

Management of 112 cases with capsule endoscope gastric retention

目的比较药物和胃镜两种方式处理胶囊内镜胃内滞留的有效性及安全性。方法回顾性分析胶囊内镜胃内滞留患者112例的临床资料。其中,36例肌肉注射胃复安5 mg(药物组),41例采用胃镜推送送至十二指肠球部(球部组),35例采用胃镜推送送至十二指肠降部(降部组)。分析胶囊内镜胃内滞留处理成功率、胶囊内镜反流率、盲肠到达率和不良事件发生情况。结果内镜组所有患者经胃镜成功处理胶囊滞留,处理成功率高于药物组的86.11%(P<0.05)。安全性方面,内镜组不良事件发生率较药物组稍高(P>0.05)。药物组5例在成功处理后出现胶囊反流,球部组2例发生胶囊反流(P<0.05)。药物组胶囊内镜最终盲肠到达率72.22%,低于球部组的92.68%和降部组的91.43%(P<0.05)。结论与药物处理比较,经胃镜抓取胶囊内镜直接送至十二指肠的处理方法更为可靠有效,同时也能保证检查的完整性。

Objective To compare the efficacy and safety of drug and gastroscope in the management of capsule endoscope gastric retention.Methods One hundred and twelve patients with capsule endoscope gastric retention were treated with intramuscular injection of metoclopramide 5 mg(group A,36 cases),sending capsule endoscope directly into duodenal bulb by gastroscope(group B,41 cases)or sending capsule endoscope directly into lower duodenum by gastroscope(group C,35 cases).The success rate of treatment,capsule endoscopic reflux rate,cecum arrival rate,and incidence of adverse events were analyzed.Results The capsule endoscope gastric retention was treated successfully in all the patients in groups of B and C with the success rate of 100%,which was higher than 86.11%in group A(P<0.05).The incidence of adverse events in groups of B and C was slightly higher than that in group A(P>0.05).The capsule endoscopic reflux after treated occurred in 5 cases of group A,which happened in 2 cases of group B(P<0.05).The final cecum arrival rate of the capsule endoscope in group A was 72.22%,which was significantly lower than 92.68%in group B or 91.43%in group C(P<0.05).Conclusion Compared with drug treatment of capsule endoscope gastric retention,sending the capsule endoscope directly into duodenal bulb or lower duodenum by gastroscope is more reliable and effective and can guarantee the completeness of the examination.