消化胶囊内镜对不明原因消化道出血诊断价值研究.docVIP

消化胶囊内镜对不明原因消化道出血诊断价值研究 　　[摘要] 目的：探讨消化胶囊内镜对不明原因消化道出血的诊断价值。方法：回顾性分析2007年1月～2009年1月因不明原因消化道出血入选我院胶囊内镜检查的患者128例，分析其一般资料、出血类型及检查结果。结果：共纳入128例不明原因消化道出血患者，其中83例（64.8%）获阳性结果。根据出血类型分为显性出血者82例，隐性出血者46例，组间阳性诊断率比较，差异均无统计学意义（均P0.05）。血管发育异常为最常见病因，其次为小肠恶性肿瘤。结论：胶囊内镜在不明原因消化道出血的检查中安全、无创，患者痛苦少，且阳性诊断率高，值得临床推广应用。 　　[关键词] 消化胶囊内镜；不明原因消化道出血；诊断 　　[中图分类号] R573;R574 [文献标识码] Ａ [文章编号] 1673-7210（2011）11（a）-060-02 　　 　　Diagnostic value of capsule endoscopy in obscure gastrointestinal bleeding 　　LONG Jinghua, CHEN Yaohua, LIANG Nongliang, LIANG Jian, ZHANG Guo′an, ZHI Fachao 　　Department of Digestion, the People′s Hospital in Jiangmen City of Guangdong Province, Jiangmen 529020, China 　　[Abstract] Objective: To evaluate the effect of capsule endoscopy in patients with obscure gastrointestinal bleeding. Methods: The data of 128 patients referred in our hospital from January 2007 to January 2009 for the investigation of obscure gastrointestinal bleeding were retrospectively analyzed. Their general information, bleeding patterns and test results were collected for analysis. Results: A total of 83 patients (64.8%) were obtained positive findings. 82 patients were presented with overt obscure gastrointestinal bleeding while 46 patients with occult obscure gastrointestinal bleeding, and there was no significant difference between the two groups (all P0.05). Angiodysplasias were the most frequent lesions identified, m alignant tumor of small intestine were less frequently seen. Conclusion: Capsule endoscopy is a safe, non-invasive method, less pain for the patients, and positive diagnosis rate is high, it is worthy of clinical use. 　　[Key words] Capsule endoscopy; Obscure gastrointestinal bleeding; Diagnosis 　　不明原因的消化道出血是指消化内镜（包括结肠镜和上消化道内镜）检查阴性、不明来源的持续或反复发作的出血，病变部位常位于小肠。在???囊内镜及双气囊、单气囊小肠镜问世之前，对明确不明原因消化道出血患者的出血部位判断难度较大，常用的检查手段如全消化道钡餐、血管造影、传统推进式小肠镜等仅能明确部分出血原因，有时需要通过剖腹探查及术中肠镜检查明确，甚至行小肠盲目切除术。小肠镜虽能完成全小肠检查，但由于操作技术要求高，操作时间长，受检者痛苦大以及检查中并发症发生率高[1]等原因不能被大多数患者所接受。胶囊内镜的问世，为查找不明原因消化道出血的病变部位带来了希望，胶囊内镜具有无痛性、