不同年龄不明原因消化道出血患者胶囊内镜诊断效果分析

Effect of capsule endoscopy in diagnosis of obscure gastrointestinal bleeding in patients of different ages

目的探讨不同年龄不明原因消化道出血(OGIB)患者的胶囊内镜诊断效果。方法选择2017年1月至2020年10月郑州市第七人民医院收治的128例OGIB患者为研究对象,根据年龄将患者分为青年组(18~44岁,n=40)、中年组(45~59岁,n=42)和老年组(≥60岁,n=46)。所有患者行胶囊内镜检查,比较3组患者病变检出和诊断情况。结果青年组、中年组和老年组患者病变检出率分别为80.00%(32/40)、80.95%(34/42)、91.30%(42/46);老年组患者病变检出率显著高于青年组和中年组(χ^(2)=12.563、10.851,P<0.05);青年组与中年组患者病变检出率比较差异无统计学意义(χ^(2)=9.635,P>0.05)。青年组、中年组和老年组患者消化道出血诊断明确率分别为95.00%(38/40)、95.23%(40/42)、95.65%(44/46);3组患者消化道出血诊断明确率比较差异无统计学意义(χ^(2)=1.998,P>0.05)。OGIB患者以血管发育不良、克罗恩病、间质瘤、非特异性小肠炎、憩室等病变为主。青年组OGIB患者以克罗恩病、血管瘤、非特异性小肠炎和憩室等病变为主,中年组OGIB患者以血管发育不良、间质瘤、克罗恩病和非特异性小肠炎等病变为主,老年组OGIB患者以血管发育不良、小肠多发溃疡、息肉和非特异性小肠炎等病变为主。结论胶囊内镜对不同年龄OGIB患者的病变均有较好的检出率和出血诊断明确率,其对老年患者的病变检出率显著高于青年和中年患者;OGIB患者以血管发育不良、克罗恩病、间质瘤、非特异性小肠炎、憩室等病变为主。

Objective To investigate the effect of capsule endoscopy in the diagnosis of obscure gastrointestinal bleeding(OGIB) in patients of different ages.Methods A total of 128 patients with OGIB treated in the Seventh People′s Hospital of Zhengzhou from January 2017 to October 2020 were selected as the research subjects.The patients were divided into young group(18-44 years old, n=40),middle-aged group(45-59 years old, n=42) and elderly group(≥60 years old, n=46) according to the age.All patients were performed with capsule endoscopy, and the detection and diagnosis of lesions were compared among the three groups.Results The detection rate of lesions in the young group, middle-aged group and elderly group was 80.00%(32/40),80.95%(34/42) and 91.30%(42/46),respectively.The detection rate of lesions in the elderly group was significantly higher than that in the young group and middle-aged group(χ^(2)=12.563,10.851;P<0.05).There was no significant difference in the detection rate of lesions between the young group and middle-aged group(χ^(2)=9.635,P>0.05).The definite diagnosis rate of gastrointestinal bleeding in the young group, middle-aged group and elderly group was 95.00%(38/40),95.23%(40/42) and 95.65%(44/46),respectively.There was no significant difference in the definite diagnosis rate of gastrointestinal bleeding among the three groups(χ^(2)=1.998,P>0.05).The main lesions of patients with OGIB were vascular dysplasia, Crohn′s disease, interstitial tumor, nonspecific enteritis and diverticulum.The main lesions of patients with OGIB in the young group were Crohn′s disease, hemangioma, nonspecific enteritis and diverticulum.The main lesions of patients with OGIB in the middle-aged group were vascular dysplasia, interstitial tumor, Crohn′s disease and nonspecific enteritis.The main lesions of patients with OGIB in the elderly group were vascular dysplasia, multiple ulcers of small intestine, polyps and nonspecific enteritis.Conclusion The detection rate and diagnostic rate of capsule endoscopy in OGIB patients of different ages are better, and the detection rate of lesions in elderly patients is significantly higher than that in the young and middle-aged patients.The main lesions of patients with OGIB were vascular dysplasia, Crohn′s disease, interstitial tumor, nonspecific enteritis, diverticulum and so on.