克罗恩病的小肠受累情况：无线胶囊内镜与计算机断层扫描小肠造影的前瞻性比较
Small bowel involvement in Crohn's disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis.
作者信息
Voderholzer W A, Beinhoelzl J, Rogalla P, Murrer S, Schachschal G, Lochs H, Ortner M-A
机构信息
Medical Clinic IV-Gastroenterology/Hepatology/Endocrinology/Metabolism, Charité University Hospital, Humboldt University, Berlin, Germany.
出版信息
Gut. 2005 Mar;54(3):369-73. doi: 10.1136/gut.2004.040055.
BACKGROUND
Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in small bowel diseases.
AIM
The aim of this prospective study was to validate the gain in information and therapeutic impact of WCE in patients with Crohn's disease.
METHODS
Fifty six consecutive patients with Crohn's disease underwent computed tomography (CT) enteroclysis, and if stenoses <10 mm were excluded, WCE was carried out.
RESULTS
In 15 patients (27%), WCE could not be performed due to strictures detected by CT enteroclysis. From the other 41 patients, jejunal or ileal lesions were found in 25 patients by WCE compared with 12 by CT enteroclysis (p=0.004). This gain in information was mainly due to detection of small mucosal lesions such as villous denudation, aphthoid ulcerations, or erosions. Both methods were not significantly different in the detection of lesions in the terminal/neoterminal ileum (WCE 24 patients, CT enteroclysis 20 patients). Therapy was changed due to WCE findings in 10 patients. Consecutively, all of them improved clinically.
CONCLUSIONS
Capsule endoscopy improves the diagnosis of small bowel Crohn's disease. This may have significant therapeutic impact.
背景
无线胶囊内镜检查（WCE）可对小肠进行内镜检查，因此可能改变小肠疾病的诊断和治疗策略。
目的
本前瞻性研究的目的是验证WCE在克罗恩病患者中的信息获取及治疗效果。
方法
56例连续性克罗恩病患者接受了计算机断层扫描（CT）小肠造影检查，若排除狭窄<10mm的患者，则进行WCE检查。
结果
15例患者（27%）因CT小肠造影检查发现狭窄而无法进行WCE检查。在其他41例患者中，WCE检查发现25例患者存在空肠或回肠病变，而CT小肠造影检查发现12例（p=0.004）。信息获取的增加主要归因于对微小黏膜病变的检测，如绒毛剥脱、口疮样溃疡或糜烂。两种方法在检测终末/新终末回肠病变方面无显著差异（WCE检查发现24例患者，CT小肠造影检查发现20例患者）。10例患者因WCE检查结果而改变治疗方案。随后，所有患者临床症状均改善。
结论
胶囊内镜检查可改善小肠克罗恩病的诊断。这可能具有显著的治疗效果。
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