胶囊内镜对不明原因消化道出血的漏诊原因  

The reason of capsule endoscopic missed diagnosis of unexplained gastrointestinal bleeding

作　　者：陈涛[1] 张艳梅[2] 刘畅[1] 

机构地区：[1]吉林油田总医院内镜科,吉林松原138000 [2]吉林油田总医院肝病二科,吉林松原138000

出　　处：《中国现代医生》2017年第16期74-76,共3页China Modern Doctor

摘　　要：目的探讨胶囊内镜对不明原因消化道出血的漏诊原因。方法选择2011年1月~2016年12月在我院行胶囊内镜检查的412例不明原因消化道出血患者的临床资料进行回顾性分析。记录患者性别、年龄、病程、血红蛋白浓度、导泻剂类型、胶囊运行时间、图像质量、病变部位、病变类型。单因素及多因素分析胶囊内镜对不明原因消化道出血的漏诊原因。结果单因素分析结果显示:年龄小、Hb、憩室、末端回肠/回盲部病变、图像质量差、使用其他或者未导泻漏诊率较高(P<0.05)。多因素分析结果显示:随着年龄的增加,确诊率升高,而末端回肠/回盲部病变、憩室、图像质量差降低确诊率,增加漏诊率。结论影响胶囊内镜对不明原因消化道出血的漏诊因素包括年龄、图像质量、憩室、末端回肠/回盲部病变等,在临床工作中,应重视这些因素,降低漏诊率。Objective To explore the capsule endoscopy of unknown cause of gastrointestinal bleeding missed diagnosis of the reasons. Methods The clinical data of 412 patients with unexplained gastrointestinal bleeding who underwent capsule endoscopy from January 2011 to December 2016 were retrospectively analyzed. The sex, age, duration,hemoglobin concentration, catharticidal type, capsule running time, image quality, lesion location and lesion type were recorded. The reason of capsule endoscopic missed diagnosis of unexplained gastrointestinal bleeding was analyzed by univariate analysis and multivariate analysis. Results Univariate analysis showed that the missed diagnosis rate was high when young age, Hb, diverticulum, terminal ileum/ileocecal lesions, poor image quality, the use of other cathartic agents or no catharsis（P〈0.05）. Multivariate analysis showed that with the increase of age, the diagnosis rate was increased, while the terminal ileum/ileocecal lesions, diverticulum, poor image quality reduced the diagnosis rate and increase the rate of missed diagnosis. Conclusion The factors influencing the capsule endoscopic missed diagnosis of unexplained gastrointestinal bleeding include age, image quality, diverticulum, terminal ileum/ileocecal lesion. In clinical work, attention should be paid to these factors to reduce the rate of missed diagnosis.

关 键 词：胶囊内镜 不明原因消化道出血 漏诊原因 憩室 

分 类 号：R57[医药卫生—消化系统]