Sato Junichi, Nakamura Masanao, Watanabe Osamu, Yamamura Takeshi, Funasaka Kohei, Ohno Eizaburo, Miyahara Ryoji, Kawashima Hiroki, Goto Hidemi, Hirooka Yoshiki
Nagoya University Graduate School of Medicine, Department of Gastroenterology and Hepatology, Nagoya, Japan.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Therap Adv Gastroenterol. 2017 Jan;10(1):20-31. doi: 10.1177/1756283X16673556. Epub 2016 Nov 7.
Colon capsule endoscopy (CCE) is a procedure in which capsule swallowing facilitates observation of the lumen of the entire digestive tract. It does not require an air supply, and is a noninvasive procedure with a markedly low risk of adverse events in comparison with conventional colonoscopy (CS). It reduces patient stress, and may be acceptable to patients. A limitation of this procedure is that the entire colon observation rate (CCE excretion rate, completed CCE rate) is not 100%. In this study, we prospectively investigated clinical factors important to achieve observation of the entire colon on CCE.
The participants were 70 patients for whom CCE was scheduled, and from whom written informed consent regarding participation in this study was obtained. We selected patient background/examination factors, and analyzed all factors involved in observation of the entire colon and factors for completion of the CCE within 4 h after the start of examination using multivariate analysis.
Of the 70 enrolled patients, 64 were analyzed, excluding 6. On multiple logistic analysis, only a water intake of ⩾12.0 ml/min during examination [ = 0.025, odds ratio (OR): 46.753, 95% confidence interval (CI): 1.630-1341.248] was identified as an independent predictive factor involved in observation of the entire colon. With respect to factors involved in the completion of CCE within 4 h, multiple logistic analysis showed that a body mass index (BMI) of ⩾25 ( = 0.039, OR: 13.723, 95% CI: 1.135-165.913), the absence of constipation ( = 0.030, OR: 13.988, 95% CI: 1.287-152.047), and a water intake of ⩾12.0 ml/min during examination ( = 0.004, OR: 12.028, 95% CI: 2.225-65.029) were independent predictive factors.
Completion of a CCE was most closely related to water intake per hour. In addition to water intake, CCE-promoting factors included a high BMI and the absence of constipation.
结肠胶囊内镜检查（CCE）是一种通过吞咽胶囊来观察整个消化道管腔的检查方法。它无需供气，与传统结肠镜检查（CS）相比，是一种无创检查，不良事件风险明显较低。它能减轻患者的压力，患者可能更容易接受。该检查方法的一个局限性是全结肠观察率（CCE排泄率、CCE完成率）并非100%。在本研究中，我们前瞻性地调查了对CCE实现全结肠观察至关重要的临床因素。
研究对象为70例计划进行CCE检查且获得参与本研究书面知情同意书的患者。我们选取了患者背景/检查因素，采用多因素分析方法分析了全结肠观察所涉及的所有因素以及检查开始后4小时内完成CCE的因素。
70例入组患者中，排除6例后对64例进行了分析。多因素逻辑分析显示，仅检查期间每小时饮水量≥12.0 ml（P = 0.025，比值比[OR]：46.753，95%置信区间[CI]：1.630 - 1341.248）被确定为全结肠观察的独立预测因素。关于4小时内完成CCE的相关因素，多因素逻辑分析表明，体重指数（BMI）≥25（P = 0.039，OR：13.723，95% CI：1.135 - 165.913）、无便秘（P = 0.030，OR：13.988，95% CI：1.287 - 152.047）以及检查期间每小时饮水量≥12.0 ml（P = 0.004，OR：12.028，95% CI：2.225 - 65.029）为独立预测因素。
CCE的完成与每小时饮水量关系最为密切。除饮水量外，促进CCE的因素还包括较高的BMI和无便秘。
