磁控胶囊内镜在老年恶性肿瘤患者消化道检查中的可行性和安全性分析

Feasibility and safety analysis of magnetic controlled capsule endoscopy in digestive tract examination of the elderly patients with malignant tumors

目的探讨磁控胶囊内镜(MCCE)在老年恶性肿瘤患者消化道检查中的可行性和安全性。方法回顾性分析2019年4月-2022年9月该院消化内镜中心127例行MCCE检查患者的临床资料。根据年龄,将患者分为老年组(≥65岁,n=88)和中年组(≥40岁且<65岁,n=39),再从两组中筛选出合并恶性肿瘤的患者的临床资料,进行分析和比较。结果131例患者均接受MCCE检查,有4例老年患者因吞咽失败被排除出研究,故老年组实际纳入88例。老年组中,45.4%合并严重的心血管系统疾病(40/88),27.3%有恶性肿瘤(24/88),8.0%合并严重的呼吸系统疾病(7/88),6.8%有麻醉问题(6/88),9.1%合并神经系统疾病(8/88)。在24例老年恶性肿瘤患者中,25.0%合并严重的心血管疾病,25.0%一般状况差,20.8%合并脑转移,12.5%合并严重的呼吸功能障碍。老年组胃部P2病变的阳性诊断率(52/88,59.1%)与中年组(13/39,33.3%)比较,差异有统计学意义(P=0.013);两组溃疡阳性诊断率比较(29.5%和10.2%),差异有统计学意义(P=0.032)。在合并恶性肿瘤的患者中,两组溃疡阳性诊断率比较(45.8%和11.1%),差异有统计学意义(P=0.038)。中年组患者近端胃的清洁度和显示度评分高于老年组,差异有统计学意义(P<0.05)。结论MCCE检查在老年患者的诊疗中,尤其是合并恶性肿瘤时,未遗漏任何胃部的明显病变,总体是有效和安全的。

Objective To explore the feasibility and safety of MCCE in gastrointestinal examination of elderly patients with malignant tumors.Methods Clinical data of 127 patients who underwent MCCE examination from April 2019 to September 2022 were retrospectively analyzed.According to age,the patients were divided into the elderly group(age≥65 year-old,n=88)and the middle-aged group(40≤age<65 year-old,n=39),and the clinical data of patients with malignant tumors were screened from the two groups for analysis and comparison.Results 131 patients received MCCE examination,and 4 elderly patients were excluded from this study due to swallowing failure,so 88 elderly patients were actually included in the study.In the elderly group,45.4%had serious cardiovascular diseases(40/88),27.3%had malignant tumors(24/88),8.0%had serious respiratory diseases(7/88),6.8%had anesthesia problems(6/88),and 9.1%had neurological diseases(8/88).Among the 24 elderly patients with malignant tumors,25.0%had severe cardiovascular disease,25.0%had poor general status,20.8%had brain metastases,and 12.5%had severe respiratory dysfunction.The positive diagnosis rate of gastric P2 lesions in the elderly group(52/88,59.1%)was significantly higher than that in the middle-aged group(13/39,33.3%)(P=0.013).There was significant difference in positive rate of ulcer diagnosis between the two groups(29.5%and 10.2%)(P=0.032).In patients with malignant tumors,the positive rate of ulcer diagnosis between the two groups(45.8%and 11.1%)was statistically significant(P=0.038).The cleanliness and visualization scores of proximal stomach in the middle-aged group were higher than those in the elderly group,and the differences were statistically significant(P<0.05).Conclusion MCCE is generally effective and safe in elderly patients,especially those with malignant tumors,without missing any significant gastric lesions.