不明原因消化道出血患者胶囊内镜检查的时机选择
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摘要
目的探讨不明原因消化道出血(OGIB)患者行胶囊内镜检查的最佳时机。方法回顾性分析重庆医科大学附属第二医院和重庆市急救中心2013年1月至2014年12月接受胶囊内镜检查的OGIB患者的临床资料,按检查时机的不同分为急诊组和非急诊组,整理两组患者的临床特征、胶囊内镜检查结果、并发症、住院时间及住院费用,并进行统计学分析及比较。结果76例OGIB患者接受胶囊内镜检查,发现病变48例,病变总检出率为63.15%。急诊组病变检出率为73.68%(28/38),明显高于非急诊组的病变检出率52.63%(20/38),差异有统计学意义(P<0.05)。结论对于OGIB患者,急诊胶囊内镜病变检出率更高,条件允许时,对OGIB患者应尽早行胶囊内镜检查。
Objective To investigate the optimal time for capsule endoscopy in patients with obscure gastrointestinal bleeding(OGIB).Methods Data of 76 patients with OGIB underwent capsule endoscopy from January 2013 to December 2014 were retrospectively analyzed.They were classified into two groups:emergency capsule endoscopy and non-emergency capsule endoscopy.The demographic and clinical features and outcomes of capsule endoscopy,complications and the times of hospital stays and hospitalization expenses were compared.Results The overall diagnostic yield of capsule endoscopy was 48lesions(63.15%).The overall diagnostic yield of emergency capsule endoscopy group was 73.68%(28/38),which was significantly higher than that in non-emergency capsule endoscopy group(52.63%,20/38),with statistical difference(P<0.05).Conclusion Emergency capsule endoscopy have a higher rate of detection,patients with OGIB should receive capsule endoscopy as soon as possible.
Objective To investigate the optimal time for capsule endoscopy in patients with obscure gastrointestinal bleeding(OGIB).Methods Data of 76 patients with OGIB underwent capsule endoscopy from January 2013 to December 2014 were retrospectively analyzed.They were classified into two groups:emergency capsule endoscopy and non-emergency capsule endoscopy.The demographic and clinical features and outcomes of capsule endoscopy,complications and the times of hospital stays and hospitalization expenses were compared.Results The overall diagnostic yield of capsule endoscopy was 48lesions(63.15%).The overall diagnostic yield of emergency capsule endoscopy group was 73.68%(28/38),which was significantly higher than that in non-emergency capsule endoscopy group(52.63%,20/38),with statistical difference(P<0.05).Conclusion Emergency capsule endoscopy have a higher rate of detection,patients with OGIB should receive capsule endoscopy as soon as possible.
引文
[1]May A,Nachbar L,Ell C.Double-balloon enteroscopy(push-and-pull enteroscopy)of the small bowel:feasibility and diagnostic and therapeutic yield in patients with suspected small bowel disease[J].Gastrointest Endosc,2005,62(1):62-70.
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[4]Estevez E,Gonzalez-Conde B,Vazquez-Iglesias JL,et al.Diagnostic yield and clinical outcomes after capsule endoscopy in 100consecutive patients with obscure gastrointestinal bleeding[J].Eur J Gastroentenal Hepatol,2006,18:881-888.
[5]Ge ZZ,Chen HY,Gao YJ,et al.Best candidates for capsule endoscopy for obscure gastrointestinal bleeding[J].J Gastroentenal Hepatol,2007,22(12):2076-2080.
[6]章士正.小肠影像检查的方法及应用选择[J].中华放射学杂志,2012,46(4):298-299.
[7]Van Gossum A.Obscure digestive bleeding[J].Best Pract Res Clin Gastroenterol,2001,15(1):155-174.
[8]张以洋,韩树堂,周晓白,等.双气囊内镜和胶囊内镜诊断小肠出血的临床评价[J].中华消化内镜杂志,2010,27(8):402-405.
[9]Zhang Q,He Q,Liu J,et al.Combined use of capsule endoscopy and double-balloon enteroscopy in the diagnosis of obscuregastrointestinal bleeding[J].Hepatogastroenterol,2013,60(128):1885-1891.
[10]Suarez FC,Gonzalez LY,Blazquez GI,et al.Utility and cost of the endoscopic capsule,Three years′exprience in our center[J].Gastroentenal Hepatol,2013,36(3):121-126.
[11]郑丰平,陶力,梁艳聘,等.胶囊内镜在不明原因严重的消化道出血中的诊断作用[J].中国内镜杂志,2012,18(4):422-424.
[12]Teshima CW,Kuipers EJ,Van Zanten SV,et al.Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding:an updated Meta-Analysis[J].Gastroenterol Hepatol,2011,26(5):796-801
[13]Svarta S,Segal B,Law J,et al.Diagnostic yield of repeat capsule endoscopy and the effect on subsequent patient management[J].Canadian J Gastroenterol,2010,24(7):441-444.
[14]魏丽娜,刘子燕,郝晋雍,等.胶囊内镜下非甾体类抗炎药相关性小肠损伤特点分析[J].西部中医药,2014,27(7):128-130.
[15]卫炜,戈之铮,高云杰,等.胶囊内镜在小肠肿瘤诊断中的作用[J].中华消化杂志,2007,27(12):820-823.
[2]Wiriyapom R,Sombat T,Pradermchai K.W1587:urgent double balloon enteroscopy in patients with overt obscure gastrointestinal bleeding[J].Gastrointest Endosc,2010,71(5):365.
[3]中华消化杂志编辑委员会.不明原因消化道出血诊治推荐流程(2012年3月上海)[J].胃肠病学,2012,17(7):426-429.
[4]Estevez E,Gonzalez-Conde B,Vazquez-Iglesias JL,et al.Diagnostic yield and clinical outcomes after capsule endoscopy in 100consecutive patients with obscure gastrointestinal bleeding[J].Eur J Gastroentenal Hepatol,2006,18:881-888.
[5]Ge ZZ,Chen HY,Gao YJ,et al.Best candidates for capsule endoscopy for obscure gastrointestinal bleeding[J].J Gastroentenal Hepatol,2007,22(12):2076-2080.
[6]章士正.小肠影像检查的方法及应用选择[J].中华放射学杂志,2012,46(4):298-299.
[7]Van Gossum A.Obscure digestive bleeding[J].Best Pract Res Clin Gastroenterol,2001,15(1):155-174.
[8]张以洋,韩树堂,周晓白,等.双气囊内镜和胶囊内镜诊断小肠出血的临床评价[J].中华消化内镜杂志,2010,27(8):402-405.
[9]Zhang Q,He Q,Liu J,et al.Combined use of capsule endoscopy and double-balloon enteroscopy in the diagnosis of obscuregastrointestinal bleeding[J].Hepatogastroenterol,2013,60(128):1885-1891.
[10]Suarez FC,Gonzalez LY,Blazquez GI,et al.Utility and cost of the endoscopic capsule,Three years′exprience in our center[J].Gastroentenal Hepatol,2013,36(3):121-126.
[11]郑丰平,陶力,梁艳聘,等.胶囊内镜在不明原因严重的消化道出血中的诊断作用[J].中国内镜杂志,2012,18(4):422-424.
[12]Teshima CW,Kuipers EJ,Van Zanten SV,et al.Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding:an updated Meta-Analysis[J].Gastroenterol Hepatol,2011,26(5):796-801
[13]Svarta S,Segal B,Law J,et al.Diagnostic yield of repeat capsule endoscopy and the effect on subsequent patient management[J].Canadian J Gastroenterol,2010,24(7):441-444.
[14]魏丽娜,刘子燕,郝晋雍,等.胶囊内镜下非甾体类抗炎药相关性小肠损伤特点分析[J].西部中医药,2014,27(7):128-130.
[15]卫炜,戈之铮,高云杰,等.胶囊内镜在小肠肿瘤诊断中的作用[J].中华消化杂志,2007,27(12):820-823.