Zhao K, Yang Y F, Wang J P
Department of Gastroenterology, People's Hospital Affiliated to Shanxi Medical University, Taiyuan 030012, China.
Zhonghua Nei Ke Za Zhi. 2020 Feb 1;59(2):124-128. doi: 10.3760/cma.j.issn.0578-1426.2020.02.006.
To analyze the clinical value of capsule endoscopy (CE) in small intestinal diseases and to explore the correlation between the diagnosis and clinical characteristics. From June 2016 to April 2019, a total of 194 patients receiving CE were enrolled in the Department of Gastroenterology, Shanxi People's Hospital, including 68 patients with obscure gastrointestinal bleeding, 104 with chronic abdominal pain and 22 with diarrhea. The detection rate of small intestinal lesions by CE was 53.6%(104/194), of which gastrointestinal bleeding was 66.2% (45/68), chronic abdominal pain was 53.8%(56/104), and diarrhea was 13.6%(3/22). The first three positive diagnostic criteria of CE for gastrointestinal bleeding were non-specific inflammation, small intestinal ulcer and vascular malformation. CE findings in patients with abdominal pain were non-specific inflammation, small intestinal ulcer and Crohn's disease; while the major endoscopic presentations in patients with diarrhea were small intestinal ulcer and non-specific inflammation. Logistic regression analysis suggested that the clinical manifestations and gender were correlated with positive diagnosis by CE (0.05), and the positive diagnostic rate of CE in female patients was significantly lower than that in male patients [31.6%(25/79) vs. 51.3%(59/115), 0.05]. The diagnostic rates of CE in patients with gastrointestinal bleeding and chronic abdominal pain were similar [55.9%(38/68) vs. 41.4%(43/104)], which was significantly higher than those with diarrhea [9.1%(2/22), 0.05]. Capsule endoscopy has a high detection rate for small intestinal diseases, which could be the first choice in patients with unexplained gastrointestinal bleeding. Male patients and gastrointestinal bleeding are predictors of positive findings by CE.
分析胶囊内镜(CE)在小肠疾病中的临床价值,并探讨诊断结果与临床特征之间的相关性。2016年6月至2019年4月,山西医科大学第一医院消化内科共纳入194例行CE检查的患者,其中不明原因消化道出血68例,慢性腹痛104例,腹泻22例。CE对小肠病变的检出率为53.6%(104/194),其中消化道出血患者的检出率为66.2%(45/68),慢性腹痛患者为53.8%(56/104),腹泻患者为13.6%(3/22)。CE诊断消化道出血的前三位阳性标准为非特异性炎症、小肠溃疡和血管畸形。腹痛患者的CE表现为非特异性炎症、小肠溃疡和克罗恩病;腹泻患者的主要内镜表现为小肠溃疡和非特异性炎症。Logistic回归分析显示,临床表现及性别与CE阳性诊断相关(P<0.05),女性患者CE阳性诊断率显著低于男性患者[31.6%(25/79)比51.3%(59/115),P<0.05]。消化道出血和慢性腹痛患者的CE诊断率相近[55.9%(38/68)比41.4%(43/104)],均显著高于腹泻患者[9.1%(2/22),P<0.05]。胶囊内镜对小肠疾病有较高的检出率,可作为不明原因消化道出血患者的首选检查。男性患者及消化道出血是CE阳性结果的预测因素。