胶囊内镜在不明原因腹痛患者中的临床诊断价值

Evaluation of the clinical value of capsule endoscopy in patients with unexplained abdominal pain

目的本研究旨在评价胶囊内镜在不明原因腹痛患者中的临床诊断价值。方法回顾性研究了2019年1月-2020年11月因腹痛就诊于西安交通大学第一附属医院并行胶囊内镜检查的患者及正常对照人群,评估胶囊内镜在腹痛中的诊断价值,并分析两组人群在胶囊内镜检查结果上的差异。结果共有191例不明原因腹痛患者及25例正常对照纳入研究,均正常完成胶囊内镜检查。在腹痛组患者中,腹痛相关的阳性病变检出率为52.87%(101/191),正常组人群阳性率为20%(5/25)(P<0.01)。进一步分析,腹痛组患者中腹痛相关的重要阳性发现(溃疡、糜烂、憩室、寄生虫、肿瘤)检出率为16.23%(31/191);次要阳性结果(息肉、血管畸形、毛细血管扩张、淋巴滤泡增生、淋巴管扩张)中,息肉、血管畸形、毛细血管扩张、淋巴滤泡增生等病变在腹痛组及对照组之间无统计学差异,而小肠淋巴管扩张在腹痛患者组的检出率明显高于正常对照组(23.56%vs.4%,P<0.05,OR=7.089)。结论胶囊内镜对不明原因腹痛病因的确诊有一定的价值,但部分阳性结果与腹痛的关系有待进一步研究。

Objective To evaluate the clinical value of capsule endoscope in the diagnosis of unexplained abdominal pain.Methods We made a retrospective analysis of 191 patients with unexplained abdominal pain who sought medical help in our hospital and 25 normal controls.Capsule endoscopy was performed in both groups,small bowel lesions were detected,and clinical data were collected for further analysis.Results The total small bowel lesion detection rate was 52.87%(101/191)in abdominal pain(AP)patients and 20%(5/25)in the control group,respectively.The detection rate of significant findings(ulcers,erosions,polyps,diverticula,parasites,and neoplastic organisms)was only 16.23%(31/191)in AP patients.In the non-significant findings,no statistical difference in the detection rates for vascular malformation,capillary dilation,and lymphoid follicular hyperplasia were found between the two groups,while the detection rate of intestinal lymphangiectasia was significantly higher in the AP patients(23.56%vs.4%,P<0.05,OR=7.089).Conclusion Capsule endoscopy can be an optional choice for diagnosis of unexplained abdominal pain,while the relationship between positive findings and abdominal pain should be further investigated.