胶囊内镜和小肠镜对小肠疾病诊断价值比较  

Comparison between capsule endoscopy and balloon enteroscopy in diagnosing small bowel diseases

作　　者：蔡顺天[1] 杨云生[1] 李中原[1] 王淑芳[1] 李闻[1] 孙刚[1] 窦艳[1] 王巍峰[1] 黄启阳[1] 彭丽华[1] 

机构地区：[1]解放军总医院消化科,北京100853

出　　处：《解放军医学院学报》2015年第8期765-768,共4页Academic Journal of Chinese PLA Medical School

基　　金：解放军总医院临床科研扶持基金(2012FC-TSYS-2015)

摘　　要：目的分析胶囊内镜和小肠镜对小肠疾病的诊断价值及小肠疾病谱的构成。方法回顾性研究2003年8月-2013年12月于我院消化内科住院并行胶囊内镜和气囊式小肠镜检查的病例,对患者性别、年龄、检查适应证、检查发现、检查并发症等进行研究,比较胶囊内镜和小肠镜在小肠疾病诊断中的价值,小肠疾病谱构成情况。结果 163例接受了165次胶囊内镜检查,不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)者占57.58%,小肠疾病的总体阳性检出率为72.12%,对OGIB患者小肠疾病阳性检出率为80.00%。442例接受561次小肠镜检查,OGIB患者占55.43%,小肠疾病总体阳性检出率为64.25%,对OGIB患者小肠疾病阳性检出率为64.90%。胶囊内镜和小肠镜对小肠疾病的总体阳性检出率无统计学差异(72.12%vs 64.25%,P=0.068)。对于OGIB患者,胶囊内镜对小肠疾病的检出阳性率显著高于小肠镜(80.00%vs 64.90,P=0.007)。小肠镜检出的小肠疾病构成依次为炎症性病变(39.79%)、新生物(34.15%)、血管性病变(13.73%)、憩室(8.10%)及其他病变(4.23%)(如淋巴管扩张、绒毛萎缩等)。胶囊内镜则依次为炎症性病变(42.86%)、血管性病变(25.21%)、新生物(包括肿瘤、息肉等)(21.85%),其他病变(8.40%)及憩室(1.68%)。结论胶囊内镜和小肠镜对小肠疾病的总体阳性检出率相似,胶囊内镜对OGIB患者小肠疾病阳性检出率高于小肠镜。炎症性病变、肿瘤和血管性病变为小肠最常见疾病。Objective To compare capsule endoscopy（CE） with balloon enteroscopy in diagnosing small bowel diseases and describe the disease constitution of small bowel. Methods Clinical data about patients who underwent capsule endoscopy and balloon enteroscopy from August 2003 to December 2013 in our digestive endoscopy center, including gender, age, indication, examination finding, complication and so on, were retrospectively analyzed. The overall detection rate of small bowel diseases between capsule endoscopy and balloon enteroscopy was compared and the spectrum of small bowel diseases was described. Results One hundred and sixty-five capsule endoscopy procedures were carried out in 163 patients, obscure gastrointestinal bleeding was the most common indication（OGIB, 57.58%）. Overall detection rate of abnormal findings in the small bowel was 72.12% by capsule endoscopy, and the detection rate of capsule endoscopy for OGIB patients was 80.00%. Five hundred and sixty-one balloon enteroscopy procedures were performed in 442 patients and OGIB was the most common indication（55.43%）. Overall detection rate of abnormal findings was 64.25% by balloon enteroscopy and it was 64.90% in OGIB patients. Diagnostic yield of capsule endoscopy for small bowel diseases was similar to that of balloon enteroscopy（72.12% vs 64.25%, P=0.068）. Subgroup analysis in OGIB showed that the detection rate of capsule endoscopy was higher than that of balloon enteroscopy（80.00% vs 64.90%, P=0.007）. Small bowel diseases found in patients underwent balloon enteroscopy were as follows： inflammatory diseases（39.79%）, neoplasm（34.15%）, vascular diseases（13.73%）, diverticula（8.10%） and other gastrointestinal diseases such as lymphangiectasia and atrophy of villus（4.23%）. As for capsule endoscopy, inflammatory diseases was the most common findings（42.86%）, followed by vascular diseases（25.21%）, neoplasm（including tumors and polyps, 21.85%）, other gastrointestinal diseases（8.40%） and diverticula（1.68%

关 键 词：胶囊内镜 小肠镜 小肠疾病 不明原因消化道出血 

分 类 号：R574.5[医药卫生—消化系统]