视频囊内镜对非复杂无症状缺铁性贫血的诊断产量与负双向内镜在一个大型军事胃肠道病学计划中的负面双向内镜
Carl Kay1, Tyler H Doty2, Cassandra L Craig1
1Department of Gastroenterology, Brooke Army Medical Center, San Antonio, USA.
视频囊内镜 (VCE) 在36%的无症状患者中确定了缺铁性贫血 (IDA) 的原因,标准内镜呈阴性. 小肠血管扩张是最常见的发现,恶性瘤的检测有限.
科学领域:
- 胃肠病学 胃肠病学
- 诊断内镜检查 诊断内镜检查
- 贫血研究 贫血研究
背景情况:
- 缺铁性贫血 (IDA) 经常是由胃肠道 (GI) 出血引起的.
- 视频囊内镜 (VCE) 在标准内镜失败时,对于诊断小肠出血至关重要.
- 在无症状的IDA患者中VCE的实用性与负面的双向内镜需要进一步澄清.
研究的目的:
- 为了评估VCE在无症状患者的诊断产量与IDA和负的双向内镜.
- 确定共同的发现,并评估提交延迟对结果的影响.
主要方法:
- 在负面双向内镜检查 (费里丁<45 ng/mL) 后,对75名接受IDA的VCE患者进行了回顾性审查.
- 对VCE发现,干预,IDA持久性和住院病例的分析.
- 评估与转诊延迟 (>180天) 相关的结果.
主要成果:
- 在36%的患者中,VCE显示出异常,8%的患者产生了可操作的发现,需要重复内镜检查.
- 小肠血管扩张是最常见的异常;没有检测到小肠恶性瘤.
- 老年患者 (>65岁) 显示出异常和可采取行动的VCE发现率较高. 推延迟并没有显著影响结果.
结论:
- 在无症状的IDA患者中,VCE的诊断收益率为36%,标准内镜检测结果为阴性,主要检测血管张症.
- 在这一群体中,VCE在检测小肠恶性瘤方面发挥着有限的作用.
- 建议个性化使用VCE,推延迟似乎不会对结果产生负面影响.
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