胶囊内镜对小肠疾病的诊断价值分析

Evaluation of intestinal diseases diagnosed by capsule endoscopies

目的 了解胶囊内镜检查在国人运用的临床特性,评价胶囊内镜对国人小肠疾病的诊断价值。方法 分析55例次胶囊内镜检查的临床资料。结果 (1)53例受检者进行了55次胶囊内镜检查,成功54次,成功率为98.2％。53例受检者均耐受了检查,未出现并发症。(2)胶囊内镜在胃内滞留平均时间为44min(6～135min),小肠内滞留平均时间为334min(90～433min)。在检查记录有效期间,胶囊内镜顺利通过回盲瓣42例,未通过12例。52例胶囊在检查结束后顺利排出体外,排出平均时间为24h(5h10min～72h)。(3)检出了小肠癌、淋巴瘤、息肉、平滑肌瘤、黄色瘤、克罗恩病、非特异性炎症、蛔虫症、鞭虫症、异物及血管畸形等。结论 胶囊内镜检查操作简单、安全、有效,检查成功率高,对小肠黏膜、血管及黏膜下等病变的检出能力较小肠钡剂灌肠、血管造影为高,具有较好的诊断价值。胶囊内镜的最大缺点是观察不能重复,不能获得组织学诊断和较为准确的定位诊断。

Objective To assess the detection of intestinal lesions by capsule endoscopies in Chinese patients. Methods To review the history and outcomes of 53 patients underwent 55 times ol capsule endoscopies from April 2002 to January 2003. Results Fifty-three patients received 55 times of capsule endoscopies , only one patient failed due to weak gastric peristalsis. Complication never happened. The capsule remained in the stomach and small intestine for an average of 44 minutes (range 6 - 135 minutes) and 334 minutes (range 90 -433 minutes) respectively. Three patients did not discard the capsule properly due to the stricture of small intestine. The diseases detected were small intestinal cancer, lymphoma, polyps, leio-myoma, xanthoma, Crohns disease, intestinal erosion and congestion, ascariasis, triehuriasis, foreign body and angiodysplasia. Conclusion This study demonstrates that the manipulation of capsule endoscopy is simple and safe, and provides excellent visualization of small intestine. Capsule endoscopy is superior to radiography or angiography in detecting lesions of small intestine, but it cannot afford enough information on orien-tation and histology.