摘要
目的了解胶囊内镜在消化道疾病,特别是对小肠疾病中的临床诊断应用价值。方法2004年2月至2006年2月间,应用 GIVEN 公司产 M2A 胶囊内镜检查74例,其中53例患者(分为不明原因消化道出血30例,反复发作腹痛、腹泻患者23例)经过胃镜和结肠镜检查,41例未发现可解释疾病的阳性结果,12例有胃黏膜的慢性炎症、息肉或结肠息肉;21例为健康体检者。结果 0例不明原因出血的患者中,小肠病变诊断的阳性率为76.7%(23/30),其中小肠克罗恩病5例,小肠血管畸型6例,小肠黏膜糜烂11例和小肠息肉样隆起5例,其中3例经过手术证实为小肠肿瘤,1例为罕见的 Cronkhite-Canada 综合征,另有小肠憩室1例;持续腹痛、腹泻组的23例患者中,小肠病变诊断的阳性率为65.2%(15/23),其中小肠黏膜糜烂8例、回肠末端多发小溃疡7例,小肠多发息肉5例;21例健康查体者中有1例可见小肠多发细小的息肉样隆起,2例为小肠黏膜的炎症,8例为胃黏膜炎症,其余10例未见任何异常。疑诊小肠疾病的53例患者小肠病变的诊断阳性率为71.7%(38/53),胶囊内镜对出血组患者小肠黏膜病变诊断阳性率高于腹痛组,但差异无统计学意义;出血组患者胶囊在胃排空时间、小肠通过时间和排出体外时间均明显少于查体组。结论胶囊内镜对小肠疾病的诊断阳性率高,而且安全无痛苦,具有较好的临床应用价值,尤其适用于不明原因的消化道出血患者。
Objective To assess the capsule endoscopy in the diagnosis of gastrointestinal diseases, especially in the small intestine diseases. Methods 74 patients received examination by M2A capsule endoscopy from February 2004 to February 2006. They were 53 patients had been checked by gastroscopy and colonoscopy, but the results were negative in 41 patients, and 12 patients left had chronic gastritis or gastric polypi or colonic polypi. In all 53 patients, 30 of them were obscure gastrointestinal bleeding and 23 were abdominal pain or diarrhea. Results 23 of the 30 patients with obscure gastrointestinal bleeding （76.67%） were diagnosed intestinal lesion. The diseases included intestinal Crohn＇s disease 5, angiodysplasia 6, intestinal mucosa erosion 11, intestine apophysis 5 in which 3 of them were intestinal tumor approved by surgical operations, Cronkhite-Canada syndrome 1 and intestinal diverticulum 1. In the 23 patients who suffered from abdominal pain or diarrhea, 15 of 23 （65.22%） were diagnosed small intestine diseases by capsule endoscopy, including intestinal mucesa erosion 8, single or multiple little ulcers in the end of ileum 7, multipolypi in small intestine 5. Some of the patients had more than 2 kinds of lesions. In 21 healthy people, only 1 person had multipolypoid, 2 of them had inflammation in the small intestines, 8 of them had gastric diseases, and the other 10 persons were completely normal. In all suspected small intestinal disease patients, the diagnostic positive rate was 71.69% （38/53） by M2A capsule endoscopy. The diagnostic positive rate of M2A capsule endoscopy in the patients with obscure gastrointestinal bleeding was slightly higher than that in the patients with abdominal pain, but the trend was not significant. In the patients with obscure gastrointestinal bleeding, the gastric empty time, intestinal transit time and the total time of the M2A stayed in alimentary tract were significantly shorter than that in control group. The images of M2A capsule endoscopy were clear, and nobody felt uncomfortable or had complications during the processes. All of the capsules were discharged successfully in one week. Conclusion M2A capsule endoscopy with its high diagnostic rates and safty may be a good method in the diagnosis of small intestinal diseases, especially in the patients with obscure gastrointestinal bleeding.
出处
《中华消化内镜杂志》
2007年第3期172-176,共5页
Chinese Journal of Digestive Endoscopy
关键词
小肠疾病
诊断
消化道出血
胶囊内镜
Small intestinal diseases
Diagnosis
Gastrointestinal bleeding
Capsule endoscopy
