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目的了解胶囊内镜在消化道疾病,特别是对小肠疾病中的临床诊断应用价值。方法2004年2月至2006年2月间,应用 GIVEN 公司产 M2A 胶囊内镜检查74例,其中53例患者(分为不明原因消化道出血30例,反复发作腹痛、腹泻患者23例)经过胃镜和结肠镜检查,41例未发现可解释疾病的阳性结果,12例有胃黏膜的慢性炎症、息肉或结肠息肉;21例为健康体检者。结果 0例不明原因出血的患者中,小肠病变诊断的阳性率为76.7%(23/30),其中小肠克罗恩病5例,小肠血管畸型6例,小肠黏膜糜烂11例和小肠息肉样隆起5例,其中3例经过手术证实为小肠肿瘤,1例为罕见的 Cronkhite-Canada 综合征,另有小肠憩室1例;持续腹痛、腹泻组的23例患者中,小肠病变诊断的阳性率为65.2%(15/23),其中小肠黏膜糜烂8例、回肠末端多发小溃疡7例,小肠多发息肉5例;21例健康查体者中有1例可见小肠多发细小的息肉样隆起,2例为小肠黏膜的炎症,8例为胃黏膜炎症,其余10例未见任何异常。疑诊小肠疾病的53例患者小肠病变的诊断阳性率为71.7%(38/53),胶囊内镜对出血组患者小肠黏膜病变诊断阳性率高于腹痛组,但差异无统计学意义;出血组患者胶囊在胃排空时间、小肠通过时间和排出体外时间均明显少于查体组。结论胶囊内镜对小肠疾病的诊断阳性率高,而且安全无痛苦,具有较好的临床应用价值,尤其适用于不明原因的消化道出血患者。
Objective To understand the clinical value of capsule endoscopy in the diagnosis of gastrointestinal diseases, especially in small intestinal diseases. Methods From February 2004 to February 2006, 74 patients were diagnosed by GIVEN M2A capsule endoscopy. Among them, 53 patients (including 30 cases of gastrointestinal bleeding caused by unknown causes, recurrent abdominal pain and 23 cases of diarrhea) were examined by gastroscope And colonoscopy, 41 cases did not find a positive result to explain the disease, 12 cases of chronic inflammation of the gastric mucosa, polyps or colon polyps; 21 cases were healthy subjects. Results Among the 0 patients with unexplained hemorrhage, the positive rate of diagnosis of small intestine lesions was 76.7% (23/30), including 5 cases of small bowel Crohn’s disease, 6 cases of intestinal vascular malformation, 11 cases of small intestinal mucosal erosion and small intestine polypoid 5 cases were diagnosed as small intestine tumor by surgery, 1 case was rare Cronkhite-Canada syndrome and another case was small bowel diverticulum. Among the 23 patients with continuous abdominal pain and diarrhea group, the positive rate of diagnosis of small intestine lesions was 65.2 % (15/23), of which 8 cases of small intestine mucosal erosion, multiple small ulcers in the terminal ileum in 7 cases, 5 cases of multiple polyps in the small intestine; 1 case of 21 cases of physical examination showed multiple small polyps of the small intestine uplift, 2 cases Intestinal mucosal inflammation, 8 cases of gastric mucosal inflammation, the remaining 10 cases without any abnormalities. The positive rate of small bowel lesions in 53 patients with suspected small intestinal disease was 71.7% (38/53). The positive rate of diagnosis of small intestinal mucosal lesions in capsule endoscopy patients was higher than that of abdominal pain patients, but the difference was not statistically significant. Patients in the gastric emptying time capsule, intestinal transit time and time were significantly less than the physical examination group. Conclusion Capsule endoscopy for the diagnosis of small bowel disease positive rate, and safe and painless, has good clinical value, especially for patients with unexplained gastrointestinal bleeding.