CAJ | 학술논문

目的评估胶囊内镜对不明原因消化道出血(OGIB)的诊断率及其对进一步诊治所起的指导作用,分析因此对OGIB患者预后结局产生的影响.方法选择2002年6月至2010年10月间因OGIB行胶囊内镜检查,符合入组标准、获得随访的患者307例,通过查阅患者资料库、住院病史以及在取得患者知情同意后,获取临床和随访数据.根据胶囊内镜检查结果,用其他方法进一步检查,并指导治疗.通过设置验证标准计算胶囊内镜检查的诊断率、敏感度、特异度、阳性预测值、阴性预测值、确诊率,以及根据胶囊内镜诊断指导治疗的有效干预率.结果 307例患者随访13 ～112个月,中位随访时间52个月.胶囊内镜诊断率65.8％、敏感度81.7％、特异度91.4％、阳性预测值95.2％、阴性预测值70.5％、确诊率84.8％.胶囊内镜阳性患者中特异性治疗的有效干预率94.5％、总体有效干预率为94.7％.结论胶囊内镜检查对OGIB诊断是有效的,具有较高的诊断率及准确性,可指导临床医师对患者采取进一步的诊治措施,从而较大程度上改善这些患者的预后.
목적 평고효낭내경대불명원인소화도출혈(OGIB)적진단솔급기대진일보진치소기적지도작용,분석인차대OGIB환자예후결국산생적영향.방법 선택2002년6월지2010년10월간인OGIB행효낭내경검사,부합입조표준、획득수방적환자307례,통과사열환자자료고、주원병사이급재취득환자지정동의후,획취림상화수방수거.근거효낭내경검사결과,용기타방법진일보검사,병지도치료.통과설치험증표준계산효낭내경검사적진단솔、민감도、특이도、양성예측치、음성예측치、학진솔,이급근거효낭내경진단지도치료적유효간예솔.결과 307례환자수방13 ～112개월,중위수방시간52개월.효낭내경진단솔65.8％、민감도81.7％、특이도91.4％、양성예측치95.2％、음성예측치70.5％、학진솔84.8％.효낭내경양성환자중특이성치료적유효간예솔94.5％、총체유효간예솔위94.7％.결론 효낭내경검사대OGIB진단시유효적,구유교고적진단솔급준학성,가지도림상의사대환자채취진일보적진치조시,종이교대정도상개선저사환자적예후.
Objective Assessed the efficiency of capsule endoscopy in obscure gastrointestinal bleeding (OGIB) diagnosis and the reference value of diagnosis results in further clinical treatment,analyzed how capsule endoscopy results can affect patients' prognosis.Methods 307 consecutive patients who underwent capsule endoscopy for OGIB from June 2002 to October 2010 were enrolled.Follow-up data were obtained by reviewing medical records,capsule endoscopy database and contacting the patients or their relatives by telephone.We set validation criteria to calculate the capsule endoscopy inspection sensitivity,specificity,positive predictive value,negative predictive value,the accuracy.And by comparing the clinical treatment and prognosis of capsule endoscopy-positive patients with those of capsule endoscopy-negative ones,we analyzed how capsule endoscopy results can guide clinical treatment and its effect on prognosis.Results Among the patients who perform capsule endoscopy for OGIB,307 patients follow-up data were available,with a medium follow-up of 52.0 (range 13-112,interquartile range 33-74) months.In this study,the diagnostic yield of capsule endoscopy is 65.8％,and the accuracy is 84.8％.Sensitivity,specificity,positive predictive value and negative predictive value of capsule endoscopy were 81.7％,91.4％,95.2％ and 70.5％,respectively.The effective intervention rate of specific treatments in capsule endoscopy-postive patients was 94.5％,while the total effective intervention rate was 94.7％.Conclusion Capsule endoscopy for OGIB is an effective and safe method with excellent tolerability as well as high diagnostic yield and accuracy,able to effectively guide the clinicians to proper diagnosis and treatment,thus greatly improving the prognosis of these patients.