磁控胶囊内镜在不明原因慢性腹痛中的临床应用价值

摘要

Background:Obscure chronic abdominal pain is one of the common clinical symptoms of digestive system disease, which mainly associated with small bowel disease. Magnetically guided capsule endoscopy can observe the pathological change of whole small intestine and improve the diagnostic efficacy of the disease. Aims:To investigate the value of magnetically guided capsule endoscopy in obscure chronic abdominal pain. Methods:Patients with obscure chronic abdominal pain undergone magnetically guided capsule endoscopy from August 2015 to January 2016 at Rui Jin Hospital Luwan Branch,School of Medicine,Shanghai Jiao Tong University and Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University were enrolled retrospectively in this study. Diagnostic performance and safety of magnetically guided capsule endoscopy were analyzed. Results:A total of 46 patients were selected in this investigation. The average transit times of magnetically guided capsule endoscopy in esophagus,stomach and small intestine were (3. 2 ± 1. 2)min, (42. 3 ± 15. 7)min and (265. 8 ± 83. 6)min,respectively. The completion rate for examination of small intestine was 97. 8%(45/46). No complications such as capsule retention and intestinal obstruction were seen in all the patients. Detection rates of small intestinal lesions and gastroesophageal lesions by magnetically guided capsule endoscopy were 60. 9%(28/46)and 50. 0%(23/46),respectively. A total of 39 patients (84. 8%)had their gastrointestinal lesions detected by magnetically guided capsule endoscopy. The etiological diagnostic rate of magnetically guided capsule endoscopy for obscure chronic abdominal pain was 78. 3%(36/46). Conclusions:Magnetically guided capsule endoscopy has the advantages of safety and non-invasiveness and can be used in diagnosis of obscure chronic abdominal pain.%背景：不明原因慢性腹痛是消化系统疾病常见临床症状之一，主要与小肠疾病有关。磁控胶囊内镜可观察全小肠黏膜病变，有助于提高疾病诊断率。目的：探讨磁控胶囊内镜在不明原因慢性腹痛中的临床应用价值。方法：回顾性纳入2015年8月—2016年1月上海交通大学医学院附属瑞金医院卢湾分院消化科和上海交通大学医学院附属仁济医院老年病科行磁控胶囊内镜检查的不明原因慢性腹痛患者，分析磁控胶囊内镜的诊断效能和安全性。结果：共46例患者纳入研究，磁控胶囊内镜在食管、胃、小肠内的平均运行时间分别为（3．2±1．2）min、（42．3±15．7）min和（265．8±83．6）min，全小肠检查完成率为97．8％（45／46），所有患者均未发生胶囊滞留、肠梗阻等并发症。磁控胶囊内镜的小肠病变检出率为60．9％（28／46），上消化道病变检出率为50．0％（23／46）。共39例（84．8％）患者经磁控胶囊内镜检出阳性病变，磁控胶囊内镜对不明原因慢性腹痛的病因诊断率为78．3％（36／46）。结论：磁控胶囊内镜检查安全、无创，对不明原因慢性腹痛有较高的诊断价值。