25例不明原因小肠出血的胶囊内镜检查分析  

Evaluation of bleeding of undetermined small intestinal origin by capsule endoscopy results of 25 patients

作　　者：陈孝[1] 张子其[1] 张建萍[1] 张钰[1] 

机构地区：[1]解放军总医院南楼消化科,北京100853

出　　处：《中国内镜杂志》2004年第11期57-59,共3页China Journal of Endoscopy

摘　　要：目的评价胶囊内镜对不明原因小肠出血的诊断价值。方法分析该科25例不明原因小肠出血的胶囊内镜检查结果,并与小肠钡餐、血管造影进行比较。结果患者症状为:鲜血便7例、暗红色或黑便16例、便潜血阳性2例。病程平均41.08个月,贫血者血色素最低水平平均为56 g/L,13例进行了平均量为800 ml的输血治疗。25例患者中检查成功24例,检出小肠病变23例,明确小肠出血部位及病因20例,诊断率为83.33%。病因包括:血管畸形11例,平滑肌瘤4例,Crohn病1例,霍奇金淋巴瘤1例,十二指肠球炎1例,小肠糜烂或溃疡2例。胶囊内镜病变检出明显高于小肠钡餐、血管造影。结论不明原因小肠出血患者对胶囊内镜检查具有良好的耐受性,胶囊内镜是小肠出血诊断的有效手段。Objective: To assess the value of capsule endoscopy in diagnosis of bleeding of undetermined small intestinal origin and to provide the evidence for it′s clinic management. Methods: We analyzed the outcomes of the patients with obscure small bowel bleeding who accepted capsule endoscopy from July 2002 to noverber 2003. Results: 25 patients revolved in this study. There were hematochezia in 7 patients, and melena or maroon blood per rectum in 16, chronic positive fecal occult blood tests in 2. the average lowest hemoglobin level was 56 g/L (25~90% g/L), and 5 patients companied with iron-deficiency anemia, and 13 patients had been transfused an average of 800ml of red cells. Bleeding sites and pathogeny were indentified in 20 of 24 patients: carcinoma 1, leiomyoma 4, Crohn′s disease 1, anplasia 11, iliac erosion 2, duodenitis 1. The yield of capsule endoscopy was higher than that of enteroclysis and angiography. Conclusion: Capsule endoscopy is a safe and well-tolerated modality for visualizing the small bowel in patients with undermined bleeding origin.

关 键 词：胶囊内镜 小肠 出血 诊断 

分 类 号：R656.7[医药卫生—外科学]