小肠胶囊内镜中胃传输时间延长：哪些患者有风险，其影响是什么？
Prolonged Gastric Transit Time in Small-Bowel Capsule Endoscopy: Which Patients Are at Risk and What Are the Implications?
机构信息
Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), University of Minho Faculty of Medicine, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal.
出版信息
Turk J Gastroenterol. 2023 Mar;34(3):227-233. doi: 10.5152/tjg.2023.22191.
BACKGROUND
Prolonged gastric transit time is a commonly described cause for incomplete capsule endoscopy examination. This study aimed to evaluate the prevalence and identify risk factors for prolonged gastric transit time and to assess its impact on the rate of incomplete examinations.
METHODS
This is a retrospective study including patients undergoing small-bowel capsule endoscopy between January 2014 and August 2020. Patients with prolonged gastric transit time were consecutively included and patients without prolonged gastric transit time were randomized (controls) in a 1:2 ratio. Prolonged gastric transit time was defined as small-bowel capsule endoscopy remaining in the stomach for more than 1 hour, as checked with the routine use of the real-time viewer, requiring an intervention such as prokinetic administration and/or endoscopically assisted capsule delivery into the duodenum.
RESULTS
Prolonged gastric transit time occurred in 45/957 patients (prevalence 4.7%). Both groups were similar regarding small-bowel capsule endoscopy indication and inpatient status. The mean small-bowel transit was similar between groups (4 hours 48 minutes ± 2 hours 11 minutes vs. 4 hours 38 minutes ± 1 hour 36 minutes; P =.74). Prolonged gastric transit time group did not have a significant higher rate of incomplete exams (P =.44) but presented more frequently with inadequate small-bowel preparation (P <.001). Older age (P =.046), female sex (P =.004), diabetes (P =.03), and psychotropic medication use (P =.02) were risk factors for prolonged gastric transit time. In multivariate analysis, female sex (odds ratio: 4.0; P =.002) and psychotropic medication use (OR: 4.6; P =.003) were predictors of prolonged gastric transit time.
CONCLUSION
Prolonged gastric transit time was not associated with a higher rate of incomplete exams in our cohort but was associated with higher rate of inadequate small-bowel preparation. Female sex and psychotropic medication use were independent risk factors for prolonged gastric transit time.
背景
延长的胃转运时间是胶囊内镜检查不完整的常见原因。本研究旨在评估延长胃转运时间的发生率和确定其危险因素，并评估其对不完整检查率的影响。
方法
这是一项回顾性研究，纳入 2014 年 1 月至 2020 年 8 月期间行小肠胶囊内镜检查的患者。连续纳入有延长胃转运时间的患者，并以 1:2 的比例随机选择无延长胃转运时间的患者（对照组）。延长的胃转运时间定义为小肠胶囊内镜在胃中停留超过 1 小时，通过实时查看器常规检查发现，需要干预，如促动力药物治疗和/或内镜辅助胶囊递送至十二指肠。
结果
45/957 例（4.7%）患者出现延长的胃转运时间。两组患者的小肠胶囊内镜检查指征和住院状态相似。两组间小肠转运时间无显著差异（4 小时 48 分钟±2 小时 11 分钟比 4 小时 38 分钟±1 小时 36 分钟；P=.74）。延长的胃转运时间组检查不完整的发生率无显著升高（P=.44），但小肠准备不足的发生率更高（P<.001）。年龄较大（P=.046）、女性（P=.004）、糖尿病（P=.03）和使用精神药物（P=.02）是延长胃转运时间的危险因素。多变量分析显示，女性（比值比：4.0；P=.002）和使用精神药物（OR：4.6；P=.003）是延长胃转运时间的独立危险因素。
结论
在本队列中，延长的胃转运时间与不完整检查率升高无关，但与小肠准备不足的发生率升高有关。女性和使用精神药物是延长胃转运时间的独立危险因素。
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