胶囊内镜在新诊断克罗恩病患者中应用的可行性与安全性评价  

Evaluation of the feasibility and safety of capsule endoscopy in newly diagnosed Crohn's patients

作　　者：吕慧婕 冯倩 吕文 谢璐 张鸿晨 李舒丹 LYU Huijie;FENG Qian;LYU Wen;XIE Lu;ZHANG Hongchen;LI Shudan(Department of Gastroenterology,Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University,Hangzhou,Zhejiang 310003,China;不详)

机构地区：[1]西湖大学医学院附属杭州市第一人民医院消化内科,浙江杭州310003 [2]浙江省中西医结合胆胰疾病重点实验室,杭州市消化疾病研究所,浙江杭州310003

出　　处：《中华全科医学》2024年第10期1645-1647,1726,共4页Chinese Journal of General Practice

基　　金：浙江省卫生健康科技计划项目(2021KY857);杭州市卫生健康委员会(2022WJC099);杭州市卫生科技计划项目(A20220596)。

摘　　要：目的探究胶囊内镜在新诊断克罗恩病患者中作为诊断工具的可行性与安全性。方法选择2019年8月—2023年8月杭州市西湖大学附属第一人民医院新诊断的60例克罗恩病患者为研究对象,均接受胶囊内镜检查。对受试者的临床特征及胶囊内镜的观察结果进行统计,通过该检查的完成率以及不良临床事件的发生率反映其临床应用的可行性和安全性,同时分析胶囊内镜阳性检查结果的病变特征、影响因素及患者年龄对内镜检查结果的影响。结果60例患者年龄为(37.0±14.2)岁,CE检查前35.0%(21/60)的患者确诊为克罗恩病,21.7%(13/60)的患者伴随肛周病变和肠外并发症,以腹痛和腹泻为主要临床症状。胶囊内镜检查结果阳性率为80.0%(48/60),小肠通过时间为(258.5±128.2)min。59例患者顺利完成检查,1例患者发生胶囊滞留(滞留率1.7%,1/60)。CE检查发现本病最常见的病变为糜烂、溃疡、狭窄,72.9%(35/48)的患者在小肠下段病变相较于上段明显。年轻患者(≤30岁)出血、小肠上部病变为主的比例高于年龄>30岁的患者(P<0.05)。C反应蛋白(CRP)是胶囊内镜阳性结果的影响因素(P<0.05)。结论胶囊内镜在新诊断的克罗恩病患者中的应用是可行并且安全的,特别是在年轻、小肠上段病变的患者中更易检出,CRP是影响胶囊内镜阳性结果的相关因素。Objective To explore the feasibility and safety of capsule endoscopy as a diagnostic tool in newly diagnosed Crohn's patients.Methods From August 2019 to August 2023,60 patients with Crohn's disease newly diagnosed at the First People's Hospital Affiliated to West Lake University in Hangzhou were selected as the research subjects,and they all underwent capsule endoscopy.Statistics were made on the clinical characteristics of the subjects and the observation results of capsule endoscopy.The completion rate of this examination and the incidence of adverse clinical events reflect the feasibility and safety of its clinical application.Simultaneously analyze the lesion characteristics and inflence infactor of positive capsule endoscopy result,and effect of patient age on capsule endoscopy result.Results The mean age of the 60 patients was(37.0±14.2)years,and 35.0%(21/60)of the patients were diagnosed with Crohn's disease before CE examination.21.7%of the patients were accompanied by perianal lesions and parenteral complications,with abdomi-nal pain and diarrhea as the main clinical symptoms.The positive rate of capsule endoscopy was 80.0%(48/60),and the mean passage time of the small intestine was(258.5±128.2)min.59 patients successfully completed the examina-tion,and 1 patient had capsule retention(retention rate 1.7%,1/60).CE examination found that the most common le-sions of this disease were erosion,ulcer,and stenosis,and 72.9%(35/48)of patients in the lower small intestine le-sions than the upper segment.The proportion of bleeding and upper small intestine lesions in young patients(≤30 years old)was higher than that in patients>30 years old(P<0.05).CRP is a significant factor affecting the positive results of capsule endoscopy(P<0.05).Conclusion Capsule endoscopy is feasible and safe in newly diagnosed patients with Crohn's disease,especially in young patients with lesions in the upper small intestine.CRP is a related factor affecting the positive results of capsule endoscopy.

关 键 词：胶囊内镜 小肠病变 克罗恩病 安全性 有效性 

分 类 号：R574.62[医药卫生—消化系统] R574.5[医药卫生—内科学]