The Study Of Capsule Endoscopy Clinical Practice And Contrast Study With Other Diagnoses Methods For Small Intestinal Disease

Background:The small intestine long overlaps circuitously, is far away from the oral cavity and the anus, is difficult spot which the phantom study inspection diagnoses with difficulty, with the capsule and the double balloon endoscopy, small intestine radiography CT being published, filled the small intestine to lack the viewability inspection the blank, caused the small intestine disease's diagnosis to make the unprecedented progress. However, because in the capsule endoscopy has the technical limitation, simultaneously is at the clinical practice preliminary stage, needs to summarize this discipline preliminary clinical practice experience. In addition, domestic and foreign to the capsule endoscopy (CE) with double balloon endoscopy (DBE), small intestine radiography CT varies to the small intestine disease's clinical diagnosis value appraisal. Needs to summarize in the capsule endoscopy inspection clinical practice, in contrast research capsule endoscopy and double balloon endoscopy or small intestine radiography CT clinical examination potency.Objective:In summary appraisal capsule endoscopy to small intestine disease particularly small intestine hemorrhage diagnosis value, in contrastive analysis capsule endoscopy and double balloon endoscopy or small intestine radiography CT clinical practice value. Object of study and method:During 2007.12～2010.3, collected 73 to doubt to resemble the small intestine disease patient continuously, there are 65 patients with obscure gastrointestinal bleeding. Carried on the capsule endoscopy according to the standard practice, the union clinical material determines its the reliability of masculine result. The statistical analysis patient common material, the hemorrhage type, refers to Costamagna and so on grading standards determination check result which proposed. Then, through methods with medical history consult, record and telephone tracing, survey form, carried on at least 3 month-long revisits with obscure gastrointestinal bleeding patients, the revisit content including the clinical target:The inspection, the treatment, bleed and situations again blood transfusion and so on; Laboratory target:Bowel movement occult blood and hemoglobin situation. Counted the rate of hemorrhage again in the masculine group and the non-masculine group, appraises through the single variable and the multivariable data analysis bleeds the correlation factor again, understood that in the capsule endoscopy result to the risk of rebleeding rate indication function. divided into capsule endoscopy, double balloon endoscopy, the small intestine radiography CT group, analytic statistics the uniformity of these three inspection way.Results:(1) 73 patients(41men and 32 women) were studied,with a mean age of 55.1 yr.The detectable rate of capsule endoscopy was 95.9%(70/73), and positive rates was 53.4%(39/73).In 65 OGIB patients, The detectable rate was 95.4%(62/65), and positive rates was 57.0%(37/65).Angiodysplasias were the most frequent lesions identified in patients with a positive finding,interstitial tumor of small intestine were less frequent seen.The rebleeding rates of patients with a positive finding was 41.6%, with 15.4% in patients of non-positive findings. Significant difference was seen between the two groups. (P<0.05)(2) There are 11 examples in capsule endoscopy with double balloon endoscopy joint inspection, the capsule endoscopy picks out rate is 81.8%, double balloon endoscopy detection rate is 54.5.7%; In the capsule endoscopy's diagnosis rate of accuracy is 25% (3/12 example), the capsule endoscopy entire small intestine inspection finish rate is high, compares with the double balloon endoscopy, multi-stage pathological change diagnosis rate is high. There arein 5 examples in the capsule endoscopy and small intestine radiography CT inspects, both's the uniformity achieves 100%,4 example get surgeries treat, after the surgery pathology inspection confirmation for mesenchymal the lump, diagnoses consistently with the before.Conclusion:(1).Capsule endoscopy mostly detectable small intestine pathological change sign in obscure gastrointestinal bleeding patients, but the clinical masculine gender rate only reaches half, the rebleeding risk rate of the non-masculine result patients is low. (2) double balloon endoscopy surpasses rubber obviously than capsule endoscopy, capsule endoscopy at the small intestine multi-stage pathological change and in the long section pathological change's diagnosis some the fixed price value, the capsule endoscopy consistent rate was still high with small intestine radiography CT, easily,the security inspection method for the patient.