胶囊内镜对不明原因消化道出血的阳性预测因素分析  

Analysis of the predictive factors of positive capsule endoscopy findings for obscure gastrointestinal bleeding

作　　者：袁德强[1] 史维[1] 孙晓滨[1] 胡玲[1] 杨梅[1] 李姣[1] 冉文斌[1] YUAN Deqiang;SHI Wei;SUN Xiaobin;HU Ling;YANG Mei;LI Jiao;RAN Wenbin(Department of Gastroenterology,the Third People’s Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]成都市第三人民医院消化内科,四川成都610031

出　　处：《胃肠病学和肝病学杂志》2019年第4期418-421,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析胶囊内镜(caspule endoscopy, CE)对不明原因消化道出血(obscure gastrointestinal bleeding, OGIB)的阳性预测因素。方法选取成都市第三人民医院2014年6月至2018年2月因OGIB接受CE检查的104例患者作为研究对象,回顾性分析OGIB患者的性别、年龄、出血量分级、贫血程度、肠道清洁度、检查时机等临床指标与CE诊断率的关系。结果 CE检查对OGIB的诊断检出率为79.8%,诊断率为39.4%,阴性率为20.2%。单因素分析显示,最后诊断为P_2、P_1、P_0病变的三组病例中,出血量分级、出血距CE检查时间、胃通过时间、肠道清洁度评分和小肠通过时间等差异有统计学意义(P<0.05)。多元有序Logistic回归分析显示,出血距检查时间短(β=-0.294,OR=0.745,95%CI:0.635～0.874,P<0.001)和出血量大(β=1.239,OR=3.452,95%CI:1.387～8.593,P<0.008)是CE检查阳性的预测因素,充分的肠道清洁准备能提高CE的阳性诊断率。结论 CE对于OGIB是一种有效的检查手段,选择出血量较大的病例和早期行CE检查对提高诊断阳性率有较大影响。Objective To investigate the predictive factors of positive capsule endoscopy(CE)findings for obscure gastrointestinal bleeding(OGIB).Methods The data of 104 patients with OGIB who underwent small bowel CE from Jun.2014 to Feb.2018 were collected,the correlation between the diagnostic yield of CE and clinical variables such as time interval,bleeding type,age,Hb value,and Boston bowel preparation score were investigated,retrospectively.Results The detection rate,diagnostic rate and negative rate of CE for OGIB were 79.8%,39.4%and 20.2%,respectively.Univariate analysis showed that the diagnostic yield may be associated with bleeding type,time interval,gastric transit time,Boston bowel preparation score and small intestinal transit time(P<0.05).Multivariate ordinal logistic regression analysis indicated that the bleeding type and time interval were predictors for increased CE positive diagnostic rate,higher level of Boston bowel preparation score was associated with increased diagnostic rate.Conclusion CE has certain diagnostic value for OGIB,patients with overt and massive bleeding are the best candidates for CE,earlier CE,and better bowel preparation contribute to the better diagnostic yield of the procedure.

关 键 词：胶囊内镜 不明原因消化道出血 诊断价值 

分 类 号：R57[医药卫生—消化系统]