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小肠胶囊内镜检查:大学环境中的适应证、结果及临床益处

Small bowel capsule endoscopy: Indications, results, and clinical benefit in a University environment.

作者信息

Flemming Juliane, Cameron Silke

机构信息

Clinic for Gastroenterology and Gastrointestinal Oncology, University Medicine Göttingen, Göttingen St. Joseph Hospital, Berlin Tempelhof, Berlin, Germany.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0148. doi: 10.1097/MD.0000000000010148.

Abstract

Capsule endoscopy (CE) opened a new method for visualization of the small intestine. We here further explore its clinical implications.We retrospectively analyzed the clinical benefit of CE in view of medical history, diagnostics, and therapy. Our patient collective consisted of 203 patients. CE was investigated in the context of bleeding, anemia, abdominal pain, diarrhea, Crohn's disease, and suspected tumors.The study collective consisted of 118 male and 85 female patients with a mean age of 58 years (range 8-90 years). Complete bowel transit took place in 82% of the patients. The diagnostic yield in the detection of obscure gastrointestinal bleeding was 80% and for anemia 78%. Mucosal lesions were the most common finding (43%). Unclear abdominal pain had the lowest diagnostic yield (41%). Ensuing therapeutic interventions were mostly medical (66%), and to a minor extent surgical (4.4%) as well as endoscopic (4%).In conclusion, small intestinal CE is a secure method to clarify small intestinal diseases, especially obscure gastrointestinal bleeding, even in pre-operated patients without stenosis symptoms. Our study emphasizes in a collective of patients with extensive prior diagnostics that due to CE therapeutic measures resulted in 73%.

摘要

胶囊内镜(CE)为小肠可视化开辟了一种新方法。我们在此进一步探讨其临床意义。我们根据病史、诊断和治疗情况对CE的临床益处进行了回顾性分析。我们的患者群体包括203例患者。对CE在出血、贫血、腹痛、腹泻、克罗恩病和疑似肿瘤等情况下进行了研究。研究群体包括118例男性和85例女性患者,平均年龄58岁(范围8 - 90岁)。82%的患者完成了全肠道转运。不明原因胃肠道出血的诊断率为80%,贫血的诊断率为78%。黏膜病变是最常见的发现(43%)。不明原因腹痛的诊断率最低(41%)。后续的治疗干预大多是药物治疗(66%),其次是手术治疗(4.4%)和内镜治疗(4%)。总之,小肠CE是一种明确小肠疾病尤其是不明原因胃肠道出血的安全方法,即使在没有狭窄症状的术前患者中也是如此。我们的研究在一组经过广泛前期诊断的患者中强调,由于CE,73%的患者采取了治疗措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2451/5902276/40ae367dd6b4/medi-97-e0148-g001.jpg

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