Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
World J Gastroenterol. 2009 Dec 7;15(45):5740-5. doi: 10.3748/wjg.15.5740.
To investigate the diagnostic yield of capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB), and to determine whether the yield was affected by different bleeding status.
Three hundred and nine consecutive patients (all with recent negative gastric and colonic endoscopy results) were investigated with CE; 49 cases with massive bleeding and 260 cases with chronic recurrent overt bleeding. Data regarding OGIB were obtained by retrospective chart review and review of an internal database of CE findings.
Visualization of the entire small intestine was achieved in 81.88% (253/309) of cases. Clinically positive findings occurred in 53.72% (166/309) of cases. The positivity of the massive bleeding group was slightly higher than that of the chronic recurrent overt bleeding group but there was no significant difference (59.18% vs 52.69%, P > 0.05) between the two groups. Small intestinal tumors were the most common finding in the entire cohort, these accounted for 30% of clinically significant lesions. In the chronic recurrent overt bleeding group angioectasia incidence reached more than 29%, while in the massive bleeding group, small intestinal tumors were the most common finding at an incidence of over 51%. Increasing patient age was associated with positive diagnostic yield of CE and the findings of OGIB were different according to age range. Four cases were compromised due to the capsule remaining in the stomach during the entire test, and another patient underwent emergency surgery for massive bleeding. Therefore, the complication rate was 1.3%.
In this study CE was proven to be a safe, comfortable, and effective procedure, with a high rate of accuracy for diagnosing OGIB.
探讨胶囊内镜（CE）对不明原因胃肠道出血（OGIB）的诊断价值，并确定其诊断效果是否受不同出血状态的影响。
连续纳入 309 例（均近期胃镜和结肠镜检查结果阴性）OGIB 患者行 CE 检查，其中 49 例为大出血，260 例为慢性反复显性出血。通过回顾性病历分析和 CE 检查结果内部数据库回顾获取 OGIB 相关数据。
309 例患者中 81.88%（253/309）的小肠得到了充分可视化。CE 发现临床阳性结果 53.72%（166/309）。大出血组的阳性率略高于慢性反复显性出血组，但两组间无显著差异（59.18%比 52.69%，P＞0.05）。整个队列中小肠肿瘤最常见，占所有临床显著病变的 30%。在慢性反复显性出血组中，动静脉畸形的发生率超过 29%，而在大出血组中，小肠肿瘤的发生率超过 51%。患者年龄的增加与 CE 的阳性诊断率相关，OGIB 的发现也因年龄范围而异。4 例患者因胶囊在整个检查过程中一直留在胃中而受到影响，另 1 例因大出血行急诊手术。因此，并发症发生率为 1.3%。
本研究证实 CE 是一种安全、舒适、有效的检查方法，对 OGIB 的诊断准确率较高。
