Stanford University School of Medicine, Division of Gastroenterology and Hepatology, 450 Broadway Street, 4th Floor Pavilion C, MC: 6341, Redwood City, CA 94063, USA.
Best Pract Res Clin Gastroenterol. 2012 Jun;26(3):325-35. doi: 10.1016/j.bpg.2012.01.018.
Obscure gastrointestinal haemorrhage is defined the presence of overt or occult bleeding in the setting of a normal endoscopic examination of the upper and lower gastrointestinal tracts. While obscure bleeding is not common, the evaluation and management of these patients often incurs considerable expense. Potential options for small bowel evaluation include traditional radiographic studies, push enteroscopy, video capsule endoscopy, deep enteroscopy, tagged red blood cell scans, angiography, and enterography examinations with either computed tomography and/or magnetic resonance imaging. The decision regarding which modality to employ depends on the cost of the procedure, its effectiveness in rendering a diagnosis, and the potential for administration of therapy. This article will discuss determination of costs associated with technology for small bowel imaging, quality of life data associated with chronic GI haemorrhage, and available cost-effectiveness studies comparing the options for small bowel exploration.
不明原因胃肠道出血是指在上消化道和下消化道内镜检查正常的情况下出现显性或隐性出血。虽然不明原因出血并不常见，但这些患者的评估和管理往往会带来相当大的费用。小肠评估的潜在选择包括传统的放射影像学研究、推进式内镜检查、视频胶囊内镜检查、深部内镜检查、标记红细胞扫描、血管造影以及计算机断层扫描和/或磁共振成像的小肠成像检查。选择哪种方式取决于手术的成本、诊断效果以及进行治疗的可能性。本文将讨论与小肠成像技术相关的成本确定、与慢性胃肠道出血相关的生活质量数据，以及比较小肠探查选项的可用成本效益研究。
