摘要
目的分析胶囊内镜(CE)、双气囊小肠镜(DBE)在不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)中的应用价值。方法选取231例行CE和DBE检查的患者作为研究对象,按WHO年龄划分标准将OGIB患者分为青年组、中年组和老年组,回顾性分析相关临床资料,比较CE和DBE在各年龄组、不同病因中的检出情况、诊断效率、不良预后,以及大便潜血试验(FOBT)在OGIB中的诊断意义。结果CE和DBE对OGIB患者的阳性病变检出率是67.53%,前三位的病因分别是血管相关性病变、肿瘤、糜烂/溃疡,并且各病因在青年组、中年组及老年组的分布差异有统计学意义(P=0.015),CE和DBE对OGIB各种病因的诊断率差异有统计学意义(P<0.000)。CE和DBE对OGIB患者的阳性病变检出率比较,差异无统计学意义(P=0.363),但显性出血较隐性出血更容易被检出(P=0.017),FOBT阳性的患者比FOBT阴性的患者更容易检出病变(P=0.045)。CE检查的OGIB患者手术、不良反应和并发症较DBE少。结论CE和DBE在OGIB诊断中各有优势,根据患者的临床资料选择适合的检查方法,为患者带来最大的获益。
Objective To analyze the application value of capsule endoscopy(CE)and double-balloon enteroscopy(DBE)in patients with obscure gastrointestinal bleeding(OGIB).Methods 231 patients checked with CE and DBE,divided into 3 groups(young group,middle-aged group and elderly group)according to the WHO standard for age division were selected.Retrospectiving review of clinical data,compared the value of CE and DBE in detection rate,diagnostic rate,poor prognosis that including different groups and etiology,and fecal occult blood test(FOBT)in the diagnosis value of OGIB.Results The detection rate of positive lesions detected by CE and DBE of OGIB were 67.53%,and the top 3 pathogenys were vascular lesions,tumor,erosion/ulcer.The distribution of each pathogeny was different in the 3 groups(P=0.015).The diagnostic rates of CE and DBE for various OGIB pathogeny were also significantly different(P<0.000).There was no difference in the detection rate of positive lesions of OGIB between CE and DBE(P=0.363),but overt bleeding was more likely to be detected than occult bleeding(P=0.017).Patients with positive FOBT were more likely to be detected(P=0.045).CE examination of OGIB patients with less surgery,adverse reactions and complications than DBE.Conclusion CE and DBE have their respective advantages in OGIB,and appropriate examination methods can be selected according to the clinical data of patients,which will bring maximum benefit to patients.
作者
洪坤巧
邱虎
余保平
HONG Kunqiao;QIU Hu;YU Baoping(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第5期578-583,588,共7页
Chinese Journal of Gastroenterology and Hepatology
基金
国家自然科学基金(81770638)。
关键词
胶囊内镜
双气囊小肠镜
不明原因消化道出血
诊断价值
Capsule endoscopy
Double-balloon enteroscopy
Obscure gastrointestinal bleeding
Diagnostic value
