影响胶囊内镜诊断不明原因消化道出血因素的分析  

Analysis of factors that affect the diagnosis of capsule endoscopy in patients with obscure gastrointestinal bleeding

作　　者：钟慧闽[1] 王群英[1] 姚萍[1] 宋键[1] 

机构地区：[1]山东省青岛市解放军第401医院消化内科,山东青岛266071

出　　处：《胃肠病学和肝病学杂志》2009年第5期416-418,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的为提高胶囊内镜诊断不明原因消化道出血的诊断率,探讨影响胶囊内镜诊断不明原因消化道诊断率的因素。方法胶囊内镜检查172例,其中不明原因的消化道出血的患者61例,分为2组,A组为胶囊内镜检查明确出血病变者,B组为无明确出血病变者,根据年龄、性别、病史、病变程度、病变表现、排空时间、肠道清洁、检出率、诊断率等对比分析。结果消化道出血的检出率为88.52%,包括胃炎、肠炎、血管畸形、肠息肉、食管静脉曲张等。出血的诊断率为67.2%,包括小肠糜烂,克罗恩病、糜烂性胃炎、溃疡病、肿瘤等。两组病人年龄、性别比较无明显差异,A组病史活动性出血者多,病史长,合并症多,小肠转运时间较长,肠道清洁好,病变程度重,病变检出率高。结论注意病人的选择、合理的小肠转运时间、肠道清洁好、了解出血原因和排序、提高病变鉴别、图像解读及临床综合判断和随访等,可以提高胶囊内镜检查的诊断率,使不明原因消化道出血病变得到及时明确的处理。Objective To evaluate factors that affect the diagnosis of capsule endoscopy （CE） in patients with ob- scure gastrointestinal bleeding. Methods CE was performed in 172 consecutive patients. Sixty-one patients with ob- scure gastrointestinal bleeding were divided into two groups： those with documented bleeding lesions （group A） and those with non specific CE findings （group B）. Age, sex, medical history, degree of lesion, lesion performance, emp- tying time, laxative formula, detecting rate and diagnostic rate of two groups were compared. Results The detecting rate of GI bleeding was 88.52%. The diseases included gastritis, enteritis, vascular malformation, intestinal polyps, e- sophageal varices etc. The diagnostic rate of GI bleeding was 67.2%. The diseases included intestinal erosion, Crohn＇ s disease, erosive gastritis, peptic ulcers, tumor etc. There was no significant difference in sex and age between the two groups. Compared with group B, the patients of group A had more history of active bleeding, longer medical history, more complications, longer small intestine transit time, better intestinal cleaning, severity of lesion, higher lesion detec- tion rate etc. Conclusion The attention of the patient choice, reasonable small bowel transit time, good intestinal cleansing, learning causes of bleeding and sorting, improving disease identification, image interpretation and clinical general judgement and following-up etc can improve the diagnostic rate of capsule endoscopy, and make obscure gastro- intestinal bleeding lesions timely specific disposal.

关 键 词：胶囊内镜 消化道出血 

分 类 号：R57[医药卫生—消化系统]