中国全科医学 ›› 2018, Vol. 21 ›› Issue (30): 3704-3708.DOI: 10.3969/j.issn.1007-9572.2018.00.178

• 专题研究 • 上一篇    下一篇

胶囊内镜在老年小肠疾病诊断中的应用价值及安全性研究

刘献民*,张瑜,田笑笑,朱晶晶,金建军   

  1. 471003河南省洛阳市,河南科技大学临床医学院 河南科技大学第一附属医院消化内科
    *通信作者:刘献民,主治医师;E-mail:xianmliu0531@126.com
  • 出版日期:2018-10-20 发布日期:2018-10-20

The Application Value and Safety Analysis of Capsule Endoscopy in the Diagnosis of Elderly Small Intestine Diseases 

LIU Xianmin*,ZHANG Yu,TIAN Xiaoxiao,ZHU Jingjing,JIN Jianjun   

  1. Gastroenterology Department,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,China
    *Corresponding author:LIU Xianmin,Attending physician;E-mail:xianmliu0531@126.com
  • Published:2018-10-20 Online:2018-10-20

摘要: 目的 探讨胶囊内镜(CE)在老年小肠疾病诊断中的应用价值及安全性。方法 选取2015年2月—2017年2月因不明原因消化道出血(OGIB)、慢性腹痛、慢性腹泻、腹胀不适、消瘦等症状在河南科技大学第一附属医院门诊或住院接受CE检查的患者137例。按照年龄分为老年组(≥60岁,75例)和对照组(<60岁,62例)。回顾性分析两组患者的CE检查情况,包括CE在胃及小肠运行时间、胶囊排出时间、全小肠检查完成率(即胶囊在电池耗尽后通过回盲瓣进入大肠的患者比例)及胶囊滞留率(指胶囊2周或超过2周时间仍不能从消化道排出的患者比例),CE的图像质量、对小肠疾病检出率及所见病变的类型。结果 老年组CE在胃及小肠运行时间、胶囊排出时间均长于对照组(P<0.05);老年组全小肠检查完成率低于对照组(P<0.05);两组胶囊滞留率比较,差异无统计学意义(P>0.05)。老年组小肠疾病检出率(61.3%)高于对照组(43.5%)(P<0.05);老年组检出的小肠疾病以血管性病变和非甾体类抗炎药(NSAIDs)相关性黏膜损害为主,而对照组以小肠溃疡为主。老年组OGIB 的CE小肠疾病检出率高于慢性腹痛、慢性腹泻、其他症状(P<0.05)。结论 CE在老年患者消化道运行时间较长,但胶囊滞留率与中青年患者无差异,是一项安全的检查方法,并且对老年小肠疾病检出率较高,尤其对OGIB具有较好的诊断价值。

关键词: 肠疾病, 胶囊内窥镜检查, 老年人, 诊断

Abstract: Objective To investigate the usefulness and safety of capsule endoscopy (CE) for the diagnosis of small intestinal diseases in the elderly.Methods A total of 137 patients with obscure gastrointestinal bleeding (OGIB),chronic abdominal pain,chronic diarrhea,bloating,discomfort,weight loss,and other symptoms who were examined by CE as an outpatient or inpatient at the First Affiliated Hospital of Henan University of Science and Technology from February 2015 to February 2017 were selected and assigned to two groups based on age:an elderly group(≥60 years old,n=75) and a control
 group(<60 years old,n=62).The CE results were analyzed retrospectively.Parameters included the duration of CE of the stomach and small intestine,the time required for capsule excretion,the completion rate of the entire small intestine(the proportion of patients for whom the capsule passed through the ileocecal valve into the large intestine after the battery had no more power),the retention rate(the proportion of patients with the capsule in the digestive tract for 2 weeks or more),the image quality of CE,the detection rate of diseases of the small intestine,and the types of lesions observed.Results The duration of CE in the stomach and small intestine,and the amount of time until capsule excretion from the body were longer in the elderly group than in the control group(P<0.05).The completion rate of the entire small intestine examination was lower in the elderly group than in the control group(P<0.05).There was no statistically significant difference in the capsule retention rate between the two groups(P>0.05).The detection rate of small intestinal diseases was greater in the elderly group than in the control group(61.3%vs.43.5%,respectively,P<0.05).The diseases of the small intestine in the elderly group were mainly vascular lesions and mucosal damage due to the use of nonsteroidal anti-inflammatory drugs,while those in the control group were mainly intestinal ulcers.In the elderly group,the detection rate of OGIB in the small intestine was higher than that of chronic abdominal pain,chronic diarrhea,and other symptoms(P<0.05).Conclusion CE requires a longer running time in the digestive tract of elderly patients,but there was no difference in the capsule retention rate between the elderly patients and young and middle-aged patients.CE is a safe examination method with prognostic value for the detection of small intestine diseases in the elderly,especially OGIB.

Key words: Intestinal diseases, Capsule endoscopy, Aged, Diagnosis