胶囊内镜检查在三级医院不明原因胃肠道出血患者中的诊断率。
Diagnostic yield of capsule endoscopy in a tertiary hospital in patients with obscure gastrointestinal bleeding.
机构信息
Small Bowel Unit, Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands.
出版信息
J Gastrointestin Liver Dis. 2010 Jun;19(2):141-5.
BACKGROUND AND AIMS
Capsule endoscopy is applicable to several clinical conditions, but obscure gastrointestinal bleeding remains the main indication. This study aims at determining the diagnostic yield of capsule endoscopy for obscure gastrointestinal bleeding using a structured terminology in a large cohort in an academic hospital.
METHODS
In this retrospective study, 592 capsule endoscopy procedures performed in a tertiary hospital were analysed using the Capsule Endoscopy Structural Terminology. Main indications were gastrointestinal bleeding (n=142) and iron deficiency anaemia (n=240).
RESULTS
Capsule endoscopy identified abnormalities in 44% of patients with iron deficiency anaemia and in 58% of patients with gastrointestinal bleeding, resulting in a diagnostic yield of 49% for obscure gastrointestinal bleeding. In 32 patients the cause was found in the stomach and in 8 in the colon.
CONCLUSION
Capsule endoscopy evidenced a diagnostic yield of 49% for obscure gastrointestinal bleeding. Repeating endoscopy before capsule endoscopy should be considered since a reasonable proportion of lesions were found outside the small intestine.
背景与目的
胶囊内镜适用于多种临床情况，但不明原因胃肠道出血仍然是主要适应证。本研究旨在采用一种结构化术语，在一家学术医院的大样本中确定胶囊内镜对不明原因胃肠道出血的诊断率。
方法
本回顾性研究分析了在一家三级医院进行的 592 例胶囊内镜检查，采用胶囊内镜结构术语。主要适应证为胃肠道出血（n=142）和缺铁性贫血（n=240）。
结果
胶囊内镜在缺铁性贫血患者中发现异常的比例为 44%，在胃肠道出血患者中发现异常的比例为 58%，因此不明原因胃肠道出血的诊断率为 49%。32 例患者的病因在胃内，8 例在结肠内。
结论
胶囊内镜对不明原因胃肠道出血的诊断率为 49%。在进行胶囊内镜检查之前应考虑重复进行内镜检查，因为有相当一部分病变位于小肠以外。
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