目的 探讨不明原因消化道出血(OGIB)胶囊内镜的漏诊原因.方法 对133例OGIB患者进行回顾性研究,包括确诊组104例和漏诊组29例,收集两组患者的人口学特征、疾病特征和胶囊内镜特征等方面进行统计,统计内容具体包括患者年龄、性别、是否具有基础疾病,胶囊运行时间、图像质量,导泻剂类型,发病病程,血红蛋白浓度,病变部位及病变类型共10项,计量资料采用t检验,计数资料采用卡方检验,采用单因素及多因素logistic回归对相关性进行分析.结果 两组平均年龄比较差异有统计学意义(t=2.095,P=0.038),血红蛋白浓度比较差异有统计学意义(t=2.143,P=0.034),病变类型构成比较差异有统计学意义(x2=20.222,P＜0.001),病变部位分布比较差异有统计学意义(x2=33.732,P＜0.001),图像质量好差构成比较差异有统计学意义(x2=9.219,P=0.002),导泻剂类型构成比差异有统计学意义(x2=6.999,P =0.024).病变类型和病变部位分别进行卡方分割合并后再次行四格表的卡方检验显示,憩室病在两组间的构成差异具有统计学意义(x2=22.233,P＜0.001),末端回肠及回盲部病变对胶囊内镜诊断结果的影响具有统计学意义(x2=24.412,P＜0.001).单因素logsitic回归分析显示,年龄增大有利于确诊(0R=1.024,P=0.041),而血红蛋白浓度升高(OR=0.982,P =0.036)、末端回肠及回盲部病变(OR =0.110,P＜0.001)、憩室病(OR =0.102,p ＜0.001)、磷酸钠盐的使用(OR=0.367,P=0.027)、图像质量差(OR=0.258,P=0.004)均增加了漏诊风险.多因素logistic回归分析显示,导泻剂类型(P=0.05)及血红蛋白浓度(P=0.394)无统计学意义,年龄增加(OR=1.031,P=0.032)减少漏诊风险,而末端回肠及回盲部病变(OR =0.145,P=0.001)、憩室病(OR =0.118,P=0.001)、图像质量差(OR =0.245,P=0.016)是胶囊内镜漏诊的相关因素.结论 患者年龄、病变类型、病变部位、图像质量对胶囊内镜诊断结果具有较大影响,存在憩室病、末端回肠及回盲部病变、图像质量差的患者漏诊风险较大.
目的 探討不明原因消化道齣血(OGIB)膠囊內鏡的漏診原因.方法 對133例OGIB患者進行迴顧性研究,包括確診組104例和漏診組29例,收集兩組患者的人口學特徵、疾病特徵和膠囊內鏡特徵等方麵進行統計,統計內容具體包括患者年齡、性彆、是否具有基礎疾病,膠囊運行時間、圖像質量,導瀉劑類型,髮病病程,血紅蛋白濃度,病變部位及病變類型共10項,計量資料採用t檢驗,計數資料採用卡方檢驗,採用單因素及多因素logistic迴歸對相關性進行分析.結果 兩組平均年齡比較差異有統計學意義(t=2.095,P=0.038),血紅蛋白濃度比較差異有統計學意義(t=2.143,P=0.034),病變類型構成比較差異有統計學意義(x2=20.222,P＜0.001),病變部位分佈比較差異有統計學意義(x2=33.732,P＜0.001),圖像質量好差構成比較差異有統計學意義(x2=9.219,P=0.002),導瀉劑類型構成比差異有統計學意義(x2=6.999,P =0.024).病變類型和病變部位分彆進行卡方分割閤併後再次行四格錶的卡方檢驗顯示,憩室病在兩組間的構成差異具有統計學意義(x2=22.233,P＜0.001),末耑迴腸及迴盲部病變對膠囊內鏡診斷結果的影響具有統計學意義(x2=24.412,P＜0.001).單因素logsitic迴歸分析顯示,年齡增大有利于確診(0R=1.024,P=0.041),而血紅蛋白濃度升高(OR=0.982,P =0.036)、末耑迴腸及迴盲部病變(OR =0.110,P＜0.001)、憩室病(OR =0.102,p ＜0.001)、燐痠鈉鹽的使用(OR=0.367,P=0.027)、圖像質量差(OR=0.258,P=0.004)均增加瞭漏診風險.多因素logistic迴歸分析顯示,導瀉劑類型(P=0.05)及血紅蛋白濃度(P=0.394)無統計學意義,年齡增加(OR=1.031,P=0.032)減少漏診風險,而末耑迴腸及迴盲部病變(OR =0.145,P=0.001)、憩室病(OR =0.118,P=0.001)、圖像質量差(OR =0.245,P=0.016)是膠囊內鏡漏診的相關因素.結論 患者年齡、病變類型、病變部位、圖像質量對膠囊內鏡診斷結果具有較大影響,存在憩室病、末耑迴腸及迴盲部病變、圖像質量差的患者漏診風險較大.
목적 탐토불명원인소화도출혈(OGIB)효낭내경적루진원인.방법 대133례OGIB환자진행회고성연구,포괄학진조104례화루진조29례,수집량조환자적인구학특정、질병특정화효낭내경특정등방면진행통계,통계내용구체포괄환자년령、성별、시부구유기출질병,효낭운행시간、도상질량,도사제류형,발병병정,혈홍단백농도,병변부위급병변류형공10항,계량자료채용t검험,계수자료채용잡방검험,채용단인소급다인소logistic회귀대상관성진행분석.결과 량조평균년령비교차이유통계학의의(t=2.095,P=0.038),혈홍단백농도비교차이유통계학의의(t=2.143,P=0.034),병변류형구성비교차이유통계학의의(x2=20.222,P＜0.001),병변부위분포비교차이유통계학의의(x2=33.732,P＜0.001),도상질량호차구성비교차이유통계학의의(x2=9.219,P=0.002),도사제류형구성비차이유통계학의의(x2=6.999,P =0.024).병변류형화병변부위분별진행잡방분할합병후재차행사격표적잡방검험현시,게실병재량조간적구성차이구유통계학의의(x2=22.233,P＜0.001),말단회장급회맹부병변대효낭내경진단결과적영향구유통계학의의(x2=24.412,P＜0.001).단인소logsitic회귀분석현시,년령증대유리우학진(0R=1.024,P=0.041),이혈홍단백농도승고(OR=0.982,P =0.036)、말단회장급회맹부병변(OR =0.110,P＜0.001)、게실병(OR =0.102,p ＜0.001)、린산납염적사용(OR=0.367,P=0.027)、도상질량차(OR=0.258,P=0.004)균증가료루진풍험.다인소logistic회귀분석현시,도사제류형(P=0.05)급혈홍단백농도(P=0.394)무통계학의의,년령증가(OR=1.031,P=0.032)감소루진풍험,이말단회장급회맹부병변(OR =0.145,P=0.001)、게실병(OR =0.118,P=0.001)、도상질량차(OR =0.245,P=0.016)시효낭내경루진적상관인소.결론 환자년령、병변류형、병변부위、도상질량대효낭내경진단결과구유교대영향,존재게실병、말단회장급회맹부병변、도상질량차적환자루진풍험교대.
Objective To analyze the risk factors for false negative diagnosis of obscure gastrointestinal bleeding (OGIB) by capsule endoscopy.Methods A total of 133 OGIB inpatients,104 in true positive group and 29 in false negativc group,were reviewed.The features of demography,diseases and capsule endoscopy were collected and then analyzed,which included 10 variables like age,sex,time of bleeding,diseases accompanied,type and location of the disease,hemoglobin concentration,transit time of CE,quality of CE pictures and type of purgative agents.All data were analyzed with t test,and all the enumeration data were analyzed with chi square test.Logistic regression was used to analyze the correlation between the factors and results of diagnosis.Results Age ( t =2.095,P =0.038 ),concentration of hemoglobin ( t =2.143,P=0.034),type (X2 =20.222,P ＜0.001) and location (X2 =33.732,P ＜0.001) of the diseases,image quality of the CE (X2 =9.219,P =0.002 ) and the type of purgative agents (X2 =6.999,P =0.024) were found to have statistical differences between the two groups.Chi-square and partition Chi-square test revealed the occurrence of civerticulosis and lesion location,i.e.lower ileum and ileumcecum,were of statistical difference between the two groups (X2 =22.233,P ＜ 0.001 and x2 =24.412,P ＜ 0.001 ).Univariate logistic regression showed diverticulosis ( OR =0.102,P ＜0.001 ),lower bowel diseases ( OR =0.110,P ＜0.001 ),poor quality of CE pictures ( OR =0.258,P =0.004 ) and the use of sodium phosphate agent ( OR =0.367,P =0.027) were risk factors for false negative diagnosis,while older age facilitated diagnosis ( OR =1.024,P =0.041 ).However,multivariate logistic regression showed no statistic significance in type of purgative agent ( P =0.05 ) or the concentration of hemoglobin ( P =0.394).Furthermore,elder age facilitated positive diagnosis ( OR =1.031,P =0.032),while diverticulosis ( OR =0.118,P =0.001 ),lower bowel diseases ( OR =0.145,P =0.001 ) and poor quality of CE pictures ( OR =0.245,P =0.016) were correlated with higher probability of false negative diagnosis.Conclusion Age,disease type,disease location and image quality exert great influence on CE diagnosis.Diverticulosis,lower location of the diseases and poor CE image quality are risk factors for false negative diagnosis.
