Tokuhara Daisuke, Watanabe Kenji, Cho Yuki, Shintaku Haruo
Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
Digestion. 2017;96(1):46-51. doi: 10.1159/000477579. Epub 2017 Jun 22.
A patency capsule (PC) can help predict capsule endoscope (CE) retention; however, PC tolerability is unknown in children. We retrospectively evaluated PC tolerability in school-aged children.
Sixty-one patients (median age, 12.9 years; range 7.4-17.3 years) who underwent PC examination were analyzed for occurrence and determinants of ingestion difficulty and relationships between ingestion of the 2 capsules. We defined ingestion difficulty as taking 30 min or more, or failure, to ingest the PC.
Thirty-nine patients (64%) successfully ingested the PC without ingestion difficulty. The other 22 had ingestion difficulty and were significantly younger (11.7 ± 2.2 vs. 13.0 ± 1.8 years; p = 0.04) and shorter (143.3 ± 14.0 vs. 154.6 ± 12.5 cm; p = 0.003) than those without ingestion difficulty. Multivariate analysis showed that the most significant factor for predicting PC ingestion difficulty was height (cutoff value, 152 cm). Time to ingest the CE was significantly shorter than that for PC ingestion (8 ± 32 vs. 20 ± 58 min; p = 0.01). All patients indicated that ingestion of the CE was easier because of its smooth surface compared with the PC.
PC ingestion is not guaranteed in school-aged children. PC ingestion ability should be evaluated by considering the child's height and lack of experience ingesting capsules prior to PC examination.
通畅胶囊(PC)有助于预测胶囊内镜(CE)滞留;然而,儿童对PC的耐受性尚不清楚。我们回顾性评估了学龄儿童对PC的耐受性。
对61例接受PC检查的患者(中位年龄12.9岁;范围7.4 - 17.3岁)分析了吞咽困难的发生情况和决定因素,以及两种胶囊吞咽之间的关系。我们将吞咽困难定义为吞咽PC花费30分钟或更长时间,或吞咽失败。
39例患者(64%)成功吞咽PC且无吞咽困难。另外22例有吞咽困难,他们的年龄显著更小(11.7±2.2岁 vs. 13.0±1.8岁;p = 0.04),身高显著更矮(143.3±14.0 cm vs. 154.6±12.5 cm;p = 0.003)。多因素分析表明,预测PC吞咽困难的最重要因素是身高(临界值152 cm)。吞咽CE的时间显著短于吞咽PC的时间(8±32分钟 vs. 20±58分钟;p = 0.01)。所有患者均表示,与PC相比,CE因其表面光滑所以吞咽更容易。
学龄儿童不能保证能够吞咽PC。在进行PC检查前,应通过考虑儿童身高以及缺乏吞咽胶囊经验来评估其吞咽PC的能力。