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目的为提高胶囊内镜诊断不明原因消化道出血的诊断率,探讨影响胶囊内镜诊断不明原因消化道诊断率的因素。方法胶囊内镜检查172例,其中不明原因的消化道出血的患者61例,分为2组,A组为胶囊内镜检查明确出血病变者,B组为无明确出血病变者,根据年龄、性别、病史、病变程度、病变表现、排空时间、肠道清洁、检出率、诊断率等对比分析。结果消化道出血的检出率为88.52%,包括胃炎、肠炎、血管畸形、肠息肉、食管静脉曲张等。出血的诊断率为67.2%,包括小肠糜烂,克罗恩病、糜烂性胃炎、溃疡病、肿瘤等。两组病人年龄、性别比较无明显差异,A组病史活动性出血者多,病史长,合并症多,小肠转运时间较长,肠道清洁好,病变程度重,病变检出率高。结论注意病人的选择、合理的小肠转运时间、肠道清洁好、了解出血原因和排序、提高病变鉴别、图像解读及临床综合判断和随访等,可以提高胶囊内镜检查的诊断率,使不明原因消化道出血病变得到及时明确的处理。
Objective To improve the diagnosis of unexplained gastrointestinal bleeding by capsule endoscopy and to explore the factors influencing the diagnosis rate of digestive tract by unexplained capsule endoscopy. Methods 172 cases of capsule endoscopy, of which 61 cases of unexplained gastrointestinal bleeding, divided into two groups, A group of capsule endoscopy clear hemorrhagic lesions, B group of patients without definite hemorrhage, according to age, gender , History, degree of lesion, lesion performance, emptying time, intestinal cleansing, detection rate, diagnostic rate and other comparative analysis. Results The detection rate of gastrointestinal bleeding was 88.52%, including gastritis, enteritis, vascular malformation, intestinal polyps, esophageal varices and so on. The diagnosis of bleeding was 67.2%, including small bowel erosion, Crohn’s disease, erosive gastritis, ulcer disease, cancer and so on. Two groups of patients age and gender no significant difference in group A history of active bleeding, long history, complications, intestinal transit time longer, good intestinal clean, severe lesions, lesions detection rate. Conclusions Attention should be paid to the choice of patient, reasonable transit time of small intestine, good intestinal cleanness, understanding of the cause and order of hemorrhage, improvement of lesion identification, interpretation of images and comprehensive clinical judgment and follow-up, which can improve the diagnosis rate of capsule endoscopy and make unexplained causes Gastrointestinal bleeding lesions have been promptly and clearly addressed.