胶囊内镜对结肠的检查  

Use of capsule endoscopy to diagnose colon diseases

作　　者：王炳周[1] 吴灵飞[1] 李国平 杨伟昂[1] 

机构地区：[1]汕头大学医学院第二附属医院消化内科,广东省汕头市515041

出　　处：《世界华人消化杂志》2009年第19期2010-2013,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨节能控制、体位调整及适时进食在胶囊内镜完成小肠检查基础上对结肠检查的作用.方法:对我院内镜室2008-11/2009-05收治的76例患者进行胶囊内镜检查,所有病例均排除肠梗阻.将患者分为2组:第1组常规检查组(n=39);第2组体位控制组(n=37),患者吞服胶囊后,在胃窦反复拍照过程中通过图文系统发送命令减少拍照频率及灯光亮度以节约电能,观察进入小肠后让患者离开,2h再到内镜室观察,若胶囊进入结肠则采取平卧且臀部稍高的位体,同时进食普通食物观察胶囊运行,进入肝曲后采用左侧卧体位,过脾曲后改用平卧.所有患者胶囊电源耗尽后取回记录仪,同时作X光透视,了解胶囊在患者体内的位置.结果:对照组39例患者胶囊在结肠内工作时间为4±0.9h,4例(10.3%)胶囊到达直肠,35例胶囊停留于回盲部处.在回盲部处发现息肉2例(5.1%).体位控制组胶囊在结肠工作时间5±0.7h,进食后结肠运动活跃,其中19例(51.4%)于工作时间内到达升结肠以外的结肠部位.检出结肠阳性患者7例(18.9%).2组胶囊内镜结肠运行时间和疾病检查阳性率差别有统计学意义(P<0.05),对结肠检查有效率差别有显著统计学意义(P<0.01).结论:胶囊内镜检查过程采用节能控制、体位调整及进食刺激方法,有助于增加胶囊内镜有效工作时间内在结肠的运行,提高结肠疾病检出率.AIM： To explore the use of capsule endoscopy to detect colon disorders following the completion of small intestine disease diagnosis on the basis of implementation of energy consumption control for the endoscope, body position adjustment and food serving. METHODS： Seventy-six patients who received capsule endoscopy examination to exclude ileus were divided into two study groups： Group 1 （n = 39） and Group 2 （n = 37）. Patients in Group I were examined by ordinary procedures. In contrast, patients in Group 2 were examined by modified procedures. The endoscope was manipulated to reduce the frequency of photographing and the brightness of endoscopic image before the capsule reached the duodenum, Within two hours after the capsule traveled inside the duodenum, the position of the moving capsule was observed continuously while the patient＇s body position was adjusted. The patients were laid flat with buttocks slightly elevated when the capsule moved into the colon. Meanwhile, the patients were served with food. When the capsule reached the hepatic flexure, the patients were laid on their left side. When the capsule reached the splenic flexure, the patients were laid in flat position. After the capsule battery was exhausted, the recorder was retrieved. The position of the capsule inside the patient＇s body was examined by X-ray. RESULTS： Endoscopic capsules worked for 4 ± 0.9 h in the colon in Group 1. The capsules reached the recta in only four cases, and remained in the ileocecus in the other 35 cases, of which two cases of ileocecal polypi were detected. In contrast, endoscopic capsules worked for 5 ± 0.7 h in the colon in Group 2. The movement inside the colon was active after the patients took food. The capsules reached beyond the colon ascendens in 19 （51.4%） cases. Seven （18.9%） cases of colon diseases were detected in Group 2. Statistical differences were noted in the detection rate of colon diseases and the working duration of endoscopic capsules between the two groups （both P 〈

关 键 词：胶囊内镜 结肠疾病 体位调整 进食刺激 节能控制 

分 类 号：R574[医药卫生—消化系统]