【摘要】 目的探讨MiroCam@胶囊内窥镜(CE)在不同年龄段不明原因消化道出血(OGIB)检查中的应用。方法回顾性分析2015年9月至2019年2月三峡大学人民医院消化内科收治的OGIB患者临床资料。120例患者均进行CE及肠系膜动脉血管选择性数字减影血管造影(DSA)检查。按照年龄分组:老年组(n=52)、中青年组(n=48)及未成年组(n=20),观察三组患者CE检查的顺应性、安全性、并发症发生情况及病变检出情况。将CE诊断OGIB的检查结果与临床最终确诊结论进行比较。结果三组患者吞服胶囊均无困难。老年组及中青年组各有1例CE进入小肠,未成年组通过回盲瓣时间明显较老年组及中青年组缩短,老年组CE在消化道运行后排出时间显著长于中青年组及未成年组。所有患者在检查过程中耐受性良好,仅有老年组1例发生升结肠滞留并发症。DSA检查术中出现血压下降,术后出现尿潴留、穿刺点疼痛或少量渗血等多例不良反应。CE对OGIB的检出率方面,老年组(96.15%)较其他两组明显升高。CE对OGIB的总体检出率为80.83%,DSA检出率为23.33%,二者比较,差异有统计学意义(P<0.05)。CE检查的检出阳性率为54.17%,疑诊率为26.67%,检出率为80.83%,阴性率为9.17%。检测敏感性为94.85%,特异度为63.63%,阳性预测值为97.87%,阴性预测值为77.78%。结论 CE有高度的稳定性及安全性,并发症少,诊断快速,且整个检查过程简便易行,具有临床应用推广价值。更多还原

【Abstract】 Objective To explore the application of MiroCam@capsule endoscopy(CE)in the examination of unexplained gastrointestinal bleeding(OGIB)at different ages.Methods The clinical data of OGIB patients in the Department of Gastroenterology of the Three Gorges University People′s Hospital from September 2015 to February 2019 were retrospectively analyzed.All 120 patients underwent CE and mesenteric artery selective digital subtraction angiography(DSA).Grouped according to age:the elderly group(n=52),the young and middle-aged group(n=48)and the minor group(n=20),observing the compliance,safety,complications and pathological examination of the CE examination in the three groups.The results of CE diagnosis to OGIB and the final clinical diagnosis were compared.Results The three groups of patients had no difficulty swallowing capsules.The elderly group and the middle-aged group each had 1 case of CE to enter the small intestine.The ileocecal valve time in the minor group was significantly shorter than that in the elderly group and the middle-aged and younger groups.The discharge time of CE after the operation of the digestive tract in the elderly group was significantly longer than that in the middle-aged group and minor group.All patients were well tolerated during the examination,and there was only one complication of ascending colon retention in the elderly group.There were many adverse reactions such as blood pressure drop,urine retention,pain at the puncture point or a small amount of bleeding during the DSA examination.In the detection rate of CE for OGIB,the elderly group(96.15%)was significantly higher than the other two groups.The overall detection rate of CE for OGIB was 80.83%,and the detection rate of DSA was 23.33%,Comparing the two groups,the difference was statistically significant(P<0.05).The positive rate was 54.17%,the suspected rate was 26.67%,the detected rate was 80.83%and the negative rate was 9.17% of CE examination.Detection sensitivity was 94.85%,specificity was 63.63%,positive predictive value was 97.87%,negative predictive value was 77.78%.Conclusion CE has high stability and safety,few complications,rapid diagnosis,and the entire examination process is simple and easy,which has the value of clinical application and promotion.更多还原