囊内镜在患有不明显胃肠道出血的患者中的相关性 - - 一项全面的现实研究
M Vetter1,2, S Gebhardt1,2, G Kessler1,2
1Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nurnberg and Universitatsklinikum, Erlangen, Germany.
囊内镜 (CE) 是有效的诊断不清晰的胃肠道出血,特别是在患有黑色素的患者. 早期和完整的CE可以提高检测率,并指导进一步的管理,包括双气球肠镜 (DBE).
科学领域:
- 胃肠病学 胃肠病学
- 医学诊断 医学诊断 医学诊断
- 内镜检查是指内镜检查.
背景情况:
- 胃肠道出血是一个常见的问题,在标准胃镜和结肠镜检查后,5%的病例仍未被诊断出来.
- 模糊的胃肠道出血 (OGIB) 需要先进的诊断工具来识别出血源.
- 囊内镜 (CE) 和双气球肠镜 (DBE) 是调查OGIB的关键技术.
研究的目的:
- 为了评估囊内镜 (CE) 的诊断产量,在患有模糊的胃肠道出血的患者中.
- 确定影响胃肠道出血CE检测率的因素.
- 评估CE发现对后续患者管理的影响,包括使用DBE.
主要方法:
- 在德国两个中心对305名患者进行了CE,以怀疑OGIB的回顾性分析.
- 所有患者先前接受过胃镜检查和结肠镜检查,结果均为阴性.
- 用于CE的PillCam SB;分析了血液检测,患者症状,红细胞 (RBC) 输血需求,INR水平和随后的DBE程序的数据.
主要成果:
- 在63.9%的患者中,CE确定了出血源,仅在黑色素 (72.4%) 的病例中,检测率更高.
- 早期 (1日) 和完整的CE程序与明显更高的检测率有关.
- CE发现影响了DBE的决定,增加了其利用率和通过DBE检测出血源的可能性;然而,DBE并没有显著改变住院时间或红细胞输血要求.
结论:
- 囊内镜是诊断不清晰的胃肠道出血的一个有价值的工具,特别是在患有黑色素的患者中.
- 早期执行CE并确保其完整性可以最大限度地提高诊断产量.
- 在复杂的病例中,CE的发现指导了使用DBE等进一步的调查,这可能有助于提高诊断成功.
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