磁控胶囊胃镜在老年患者胃内病变筛查中的价值及视野清洁度影响因素分析  

Value of magnetic-controlled capsule gastroscope in screening of gastric lesions in elderly patients and analysis of influencing factors of visual field cleanliness

作　　者：钱雨婷[1] 白婷婷[2] 褚晔[1] 陈平[1] QIAN Yuting;BAI Tingting;CHU Ye;CHEN Ping(Department of Gastroenterology,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Geriatric,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,上海200025 [2]上海交通大学医学院附属瑞金医院老年科,上海200025

出　　处：《胃肠病学和肝病学杂志》2025年第3期326-330,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的评估磁控胶囊胃镜在老年患者胃内病变筛查中的应用价值,并分析视野清洁度的影响因素。方法选取2019年1月至2023年8月于我院消化内科进行胃内病变筛查的≥60岁的老年患者80例,观察并分析磁控胶囊胃镜的检查结果,记录胃底、贲门、胃体、胃角、胃窦和幽门的胃视野清洁度评分。根据胃视野清洁度总分(Seyed胃视野清洁度分级评分法),将患者分为图像质量良好组52例(胃视野清洁度总分>18分)和图像质量欠佳组28例(胃视野清洁度总分≤18分),对比两组的临床资料,采用Logistic回归分析影响老年患者视野清洁度的相关因素。结果80例老年患者中,发现糜烂性胃炎8例(10.00%),慢性萎缩性胃炎15例(18.75%),胆汁反流10例(12.50%),慢性浅表性胃炎40例(50.00%),胃息肉4例(5.00%),胃内食物潴留2例(2.50%),胃癌1例(1.25%)。图像质量良好组的胃底、贲门、胃体等的视野清洁度评分及其总分明显高于图像质量欠佳组(P<0.05);而两组的胃角、胃窦和幽门的视野清洁度评分相比,差异无统计学意义(P>0.05)。图像质量良好组的性别,年龄,BMI,慢性病史(高血压、糖尿病、冠心病、肺栓塞、脑梗死),临床症状(反酸、嗳气、腹胀、腹痛),抗凝及抗血小板聚集药物服用史(华法林、艾多沙班、氯吡格雷、阿司匹林),胶囊运行时间等资料与图像质量欠佳组相比,差异均无统计学意义(P>0.05);而两组的既往消化道出血病史、质子泵抑制剂使用史资料相比,差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,既往消化道出血病史、质子泵抑制剂使用史均为降低老年患者磁控胶囊胃镜检查时视野清洁度的影响因素(P<0.05)。本研究中所有接受磁控胶囊胃镜的老年患者均未出现胶囊内镜滞留情况。结论磁控胶囊胃镜诊断老年患者胃内病变的临床应用价值较高,但既往消化道出血病史、质子泵抑制剂使用史�Objective To evaluate the application value of magnetic-controlled capsule gastroscopy in screening of elderly gastric lesions,and analyze the influencing factors of visual field cleanliness.Methods Eighty elderly patients over the age of 60 years old who underwent screening for gastric lesions in our hospital from Jan.2019 to Aug.2023 were selected to observe and analyze the examination results of magnetic-controlled capsule gastroscopy,and record the cleanliness scores of gastric fields of fundus,cardia,gastric body,gastric angle,gastric antrum and pylorus.According to the total score of cleanliness of the gastric visual field(Seyed gastric visual field cleanliness grading method),the patients were divided into a group of 52 patients with good image quality(total score of cleanliness of the gastric visual field>18 points)and a group of 28 patients with poor image quality(total score of cleanliness of the gastric visual field≤18 points).The clinical data of the two groups were compared,and the related factors affecting the cleanliness of the visual field of the elderly patients were analyzed by Logistic regression.Results Among the 80 elderly patients,there were 8 cases(10.00%)of erosive gastritis,15 cases(18.75%)of chronic atrophic gastritis,10 cases(12.50%)of bile reflux,40 cases(50.00%)of chronic superficial gastritis,4 cases(5.00%)of gastric polyp,food residues occurred in 2 cases(2.50%)and gastric cancer in 1 case(1.25%).Visual field cleanliness scores and total score of gastric fundus,cardia and gastric body in good image quality group were significantly higher than those in poor image quality group(P<0.05).There was no significant difference in visual field cleanliness scores of gastric angle,antrum and pylorus between the two groups(P>0.05).There was no significant difference in gender,average age,average BMI,chronic diseases(hypertension,diabetes,coronary heart disease,pulmonary embolism,cerebral infarction),clinic complaints(acid reflux,belching,abdominal distension,abdominal pain),history of taking

关 键 词：磁控胶囊胃镜 视野清洁度 消化道出血 质子泵抑制剂 

分 类 号：R573[医药卫生—消化系统]