CAJ | 학술논문

目的：分析胶囊内镜和小肠镜对小肠疾病的诊断价值及小肠疾病谱的构成。方法回顾性研究2003年8月-2013年12月于我院消化内科住院并行胶囊内镜和气囊式小肠镜检查的病例，对患者性别、年龄、检查适应证、检查发现、检查并发症等进行研究，比较胶囊内镜和小肠镜在小肠疾病诊断中的价值，小肠疾病谱构成情况。结果163例接受了165次胶囊内镜检查，不明原因消化道出血(obscure gastrointestinal bleeding，OGIB)者占57.58%，小肠疾病的总体阳性检出率为72.12%，对OGIB患者小肠疾病阳性检出率为80.00%。442例接受561次小肠镜检查，OGIB患者占55.43%，小肠疾病总体阳性检出率为64.25%，对OGIB患者小肠疾病阳性检出率为64.90%。胶囊内镜和小肠镜对小肠疾病的总体阳性检出率无统计学差异(72.12%vs 64.25%，P=0.068)。对于OGIB患者，胶囊内镜对小肠疾病的检出阳性率显著高于小肠镜(80.00%vs 64.90，P=0.007)。小肠镜检出的小肠疾病构成依次为炎症性病变(39.79%)、新生物(34.15%)、血管性病变(13.73%)、憩室(8.10%)及其他病变(4.23%)(如淋巴管扩张、绒毛萎缩等)。胶囊内镜则依次为炎症性病变(42.86%)、血管性病变(25.21%)、新生物(包括肿瘤、息肉等)(21.85%)，其他病变(8.40%)及憩室(1.68%)。结论胶囊内镜和小肠镜对小肠疾病的总体阳性检出率相似，胶囊内镜对OGIB患者小肠疾病阳性检出率高于小肠镜。炎症性病变、肿瘤和血管性病变为小肠最常见疾病。
목적：분석효낭내경화소장경대소장질병적진단개치급소장질병보적구성。방법회고성연구2003년8월-2013년12월우아원소화내과주원병행효낭내경화기낭식소장경검사적병례，대환자성별、년령、검사괄응증、검사발현、검사병발증등진행연구，비교효낭내경화소장경재소장질병진단중적개치，소장질병보구성정황。결과163례접수료165차효낭내경검사，불명원인소화도출혈(obscure gastrointestinal bleeding，OGIB)자점57.58%，소장질병적총체양성검출솔위72.12%，대OGIB환자소장질병양성검출솔위80.00%。442례접수561차소장경검사，OGIB환자점55.43%，소장질병총체양성검출솔위64.25%，대OGIB환자소장질병양성검출솔위64.90%。효낭내경화소장경대소장질병적총체양성검출솔무통계학차이(72.12%vs 64.25%，P=0.068)。대우OGIB환자，효낭내경대소장질병적검출양성솔현저고우소장경(80.00%vs 64.90，P=0.007)。소장경검출적소장질병구성의차위염증성병변(39.79%)、신생물(34.15%)、혈관성병변(13.73%)、게실(8.10%)급기타병변(4.23%)(여림파관확장、융모위축등)。효낭내경칙의차위염증성병변(42.86%)、혈관성병변(25.21%)、신생물(포괄종류、식육등)(21.85%)，기타병변(8.40%)급게실(1.68%)。결론효낭내경화소장경대소장질병적총체양성검출솔상사，효낭내경대OGIB환자소장질병양성검출솔고우소장경。염증성병변、종류화혈관성병변위소장최상견질병。
Objective To compare capsule endoscopy (CE) with balloon enteroscopy in diagnosing small bowel diseases and describe the disease constitution of small bowel.Methods Clinical data about patients who underwent capsule endoscopy and balloon enteroscopy from August 2003 to December 2013 in ourdigestive endoscopy center, including gender, age, indication, examination finding, complication and so on, were retrospectively analyzed. The overall detection rate of small bowel diseases between capsule endoscopy and balloon enteroscopy was compared and the spectrum of small bowel diseases was described.Results One hundred and sixty-five capsule endoscopy procedures were carried out in 163 patients,obscure gastrointestinal bleeding was the most common indication (OGIB, 57.58%). Overall detection rate of abnormalfindings in the small bowel was 72.12% by capsule endoscopy, and the detection rate of capsule endoscopy for OGIB patients was 80.00%. Five hundred and sixty-one balloon enteroscopy procedures were performed in 442 patients and OGIB was the most common indication (55.43%). Overall detection rate of abnormalfindings was 64.25% by balloon enteroscopy and it was 64.90% in OGIB patients. Diagnostic yield of capsule endoscopy for small bowel diseases was similar to that of balloon enteroscopy (72.12%vs 64.25%,P=0.068). Subgroup analysis in OGIB showed that the detection rate of capsule endoscopy was higher than that of balloon enteroscopy (80.00%vs 64.90%,P=0.007). Small boweldiseases found in patients underwent balloon enteroscopy were as follows: inflammatory diseases (39.79%), neoplasm (34.15%), vascular diseases (13.73%), diverticula (8.10%) and other gastrointestinal diseases such as lymphangiectasia and atrophy of villus (4.23%). As for capsule endoscopy, inflammatory diseases was the most commonfindings (42.86%), followed by vascular diseases (25.21%), neoplasm (including tumors and polyps, 21.85%), other gastrointestinal diseases (8.40%) and diverticula (1.68%).Conclusion The diagnostic yield of capsule endoscopy for small bowel diseases is similar with balloon enteroscopy. However, the diagnostic yield of capsule endoscopy is significantly higher when performed in patients with OGIB. Inflammatory lesions, tumors and vascular diseases are relatively common in small bowel diseases.