CAJ | 학술논문

目的：评价胶囊内镜（capsule endoscopy，CE）联合双气囊小肠镜（double-balloon enteroscopy，DBE）对不明原因消化道出血（ obscure gastrointestinal bleeding ，OGIB）的临床诊断价值。方法回顾性分析85例行CE检查及部分联合DBE检查OGIB患者的临床资料。结果85例OGIB患者的病因明确诊断率为96．5％（82／85），以血管病变、小肠肿瘤、肠黏膜糜烂及溃疡性病变最常见，分别为23．5％（20／85）、21．2％（18／85）、24．7％（21／85）；行CE和DBE检查的病变检出率分别为88．2％（75／85）和95．1％（39／41）， DBE检查病因诊断率（92．7％，38／41）显著高于CE检查（51．8％，44／85），差异有统计学意义（P＜0．05）；CE和DBE检查发现血管肿瘤病变及憩室分别为21．2％（18／85）、1．2％（1／85）和48．8％（20／41）、14．6％（6／41），DBE检查对血管肿瘤病变及憩室病因的诊断率高于CE检查，差异有统计学意义（P＜0．05）。结论在OGIB患者中CE检查对血管病变、小肠肿瘤、憩室病因诊断低于DBE检查；CE与DBE联合应用能提高OGIB疾病的病因诊断率。
목적：평개효낭내경（capsule endoscopy，CE）연합쌍기낭소장경（double-balloon enteroscopy，DBE）대불명원인소화도출혈（ obscure gastrointestinal bleeding ，OGIB）적림상진단개치。방법회고성분석85례행CE검사급부분연합DBE검사OGIB환자적림상자료。결과85례OGIB환자적병인명학진단솔위96．5％（82／85），이혈관병변、소장종류、장점막미란급궤양성병변최상견，분별위23．5％（20／85）、21．2％（18／85）、24．7％（21／85）；행CE화DBE검사적병변검출솔분별위88．2％（75／85）화95．1％（39／41）， DBE검사병인진단솔（92．7％，38／41）현저고우CE검사（51．8％，44／85），차이유통계학의의（P＜0．05）；CE화DBE검사발현혈관종류병변급게실분별위21．2％（18／85）、1．2％（1／85）화48．8％（20／41）、14．6％（6／41），DBE검사대혈관종류병변급게실병인적진단솔고우CE검사，차이유통계학의의（P＜0．05）。결론재OGIB환자중CE검사대혈관병변、소장종류、게실병인진단저우DBE검사；CE여DBE연합응용능제고OGIB질병적병인진단솔。
Objective To investigate the diagnostic value of capsule endoscopy ( CE) combined with direct double-balloon enteroscopy (DBE) for patients with obscure gastrointestinal bleeding (OGIB) diseases.Methods The clinical data of 85 patients with OGIB underwent CE and part of the patients who jointed DBE examination were retrospectively analyzed .Results Diagnosed accuracy rates was 96 .5% in 85 OGIB patients ( 82/85 ) , among them , vascular dis-ease, small bowel tumors , intestinal mucosal erosions and ulcerative lesions were the most common , accounted for 23.5%(20/85), 21.2%(18/85), 24.7%(21/85), respectively.The detective rates of CE and DBE were 88.2%(75/85) and 95.1%(39/41), and their diagnosed accuracy rates were 51.8%(44/85) and 92.7%(38/41), re-spectively.DBE was superior to CE in the etiological diagnosis of OGIB (P<0.05).The vascular and tumors or diver-ticular disease rates of CE and DBE were 21.2%(18/85), 1.2% (1/85) and 48.8% (20/41), 14.6% (6/41), respectively.DBE was superior to CE in the vascular , tumors and diverticular disease of OGIB (P<0.05).Conclu-sion DBE is superior to CE in the vascular , tumors and diverticular disease of OGIB .CE combined with DBE can in-crease the diagnosed accuracy rate of OGIB .