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小肠胶囊内镜检查:来自一家大型三级医疗中心的经验。

Small Bowel Capsule Endoscopy: Experience from a single large tertiary care centre.

作者信息

Singla Neeraj, Inavolu Pradev, Jagtap Nitin, Singh Aniruddha Pratap, Kalapala Rakesh, Memon Sana Fathima, Katukuri Gowtham Reddy, Pal Partha, Nabi Zaheer, Ramchandani Mohan, Lakhtakia Sundeep, Banerjee Rupa, Reddy Palle Manohar, Tandan Manu, Reddy Nageshwar

机构信息

Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.

出版信息

Endosc Int Open. 2023 Jun 29;11(6):E623-E628. doi: 10.1055/a-2096-2453. eCollection 2023 Jun.

Abstract

Capsule endoscopy (CE) has transformed examination of the small bowel (SB), once considered a dark continent. The present study aimed to describe the indications, diagnostic yield, practical issues and complications of CE in one of the largest tertiary center in India. This retrospective analysis from a prospectively maintained database, conducted from January 2013 to June 2021 included 1155 CEs performed during this period. Patient medical records were reviewed for indications, results, and complications of CE. A total of 1154 patients (809 males and 345 females), mean age 53 years (range 6-87 years), one capsule got stuck in the esophagus, were included in the study. Active SB bleeding had no effect on SB transit time (324.7±161 minutes, n = 137 patients with active bleed vs 310.6±166.9 minutes, n = 1017 patients without active bleed; = 0.35). The indication and diagnostic yield (DY) of CE were potential overt SB bleed (68.6% & 43.9%), potential occult SB bleed (8.2% and 40%), chronic diarrhea (7.9% and 28.4%), abdominal pain (6.5% and 21.3%), anemia (5.9% and 57.9%), and suspected/known case of Crohn's disease (2.3% & 56.5%) respectively. The DY for patients with age ≥60 years was similar to those with age < 60 years (61.9% vs. 51.8% respectively; = 0.4). 21 patients (1.8%) had capsule retention of which six (0.5%) had to be referred for surgery. CE is a safe and effective investigation with ever increasing range of indications. Potential SB bleed remains the most common indication for CE with high detection rate.

摘要

胶囊内镜(CE)改变了小肠(SB)检查的现状,小肠曾被视为“黑暗大陆”。本研究旨在描述印度最大的三级医疗中心之一中CE的适应证、诊断率、实际问题及并发症。这项回顾性分析基于一个前瞻性维护的数据库,时间跨度为2013年1月至2021年6月,在此期间共进行了1155例CE检查。对患者的病历进行了回顾,以了解CE的适应证、结果及并发症。共有1154例患者(809例男性和345例女性)纳入研究,平均年龄53岁(范围6 - 87岁),有1枚胶囊卡在食管中。活动性小肠出血对小肠通过时间无影响(324.7±161分钟,137例有活动性出血患者对比310.6±166.9分钟,1017例无活动性出血患者;P = 0.35)。CE的适应证及诊断率分别为潜在显性小肠出血(68.6%和43.9%)、潜在隐匿性小肠出血(8.2%和40%)、慢性腹泻(7.9%和28.4%)、腹痛(6.5%和21.3%)、贫血(5.9%和57.9%)以及疑似/已知克罗恩病病例(2.3%和56.5%)。年龄≥60岁患者的诊断率与年龄<60岁患者相似(分别为61.9%和51.8%;P = 0.4)。21例患者(1.8%)出现胶囊滞留,其中6例(0.5%)需转诊进行手术。CE是一种安全有效的检查手段,适应证范围不断扩大。潜在小肠出血仍是CE最常见的适应证,且检出率高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a0f/10442921/5bba5c18d87e/10-1055-a-2096-2453_21029669.jpg

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