第二代结肠胶囊内镜临床应用的初步研究

Jingjing Zhang, Lan Li, Huajing Su, Youming Li
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摘要

目的探讨第二代结肠胶囊内镜(CCE-2)的临床应用。方法选取2017年7月至2018年12月在浙江大学医学院第一附属医院行CCE-2检查的门诊和住院患者40例。检查结果由具有丰富小肠和结肠胶囊内镜经验的胃肠病学专家进行分析。观察两组患者的胃、小肠、结肠转运时间、结肠清洁质量评分、结肠胶囊检查完成率、病变检出率及不良反应。采用卡方检验和Student’t检验进行统计分析。结果65.0%(26/40)患者在胶囊运行时间内完成了全胃肠道检查。胃平均通过时间为(0.92±0.74)h,小肠平均通过时间为(3.93±1.51)h,结肠平均通过时间为(4.89±0.61)h。完成全胃肠道检查的患者胶囊运行时间短于未完成全胃肠道检查的患者((9.44±3.53)h∶(15.47±2.09)h),差异有统计学意义(t=6.79, P 0.05)。结肠胶囊检出胃肠道病变33例(82.5%),其中食管病变(炎症、肿块)3例,胃病变(慢性胃炎、粘膜突出、息肉、溃疡)21例,小肠病变(息肉、溃疡、血管畸形)9例,结肠病变(憩室、息肉、直肠炎、粘膜糜烂、溃疡、血管畸形、内痔)19例。其中两处及以上病变11例。检查过程中未发生不良反应,所有胶囊均在48小时内排出。结论CCE-2安全性高,耐受性好,可用于全胃肠道检查。关键词:第二代结肠胶囊内镜;胃肠检查;结肠清洁品质;安全
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Primary study on clinical applications of second generation colon capsule endoscopy
Objective To explore the clinical applications of second generation colon capsule endoscopy (CCE-2). Methods From July 2017 to December 2018, at the First Affiliated Hospital, College of Medicine, Zhejiang University, 40 outpatients and hospitalized patients who underwent CCE-2 examination were enrolled. The examination results were analyzed by an expert gastroenterologist with rich experience in small intestinal and colon capsule endoscopy. The stomach, small bowel and colon transit time, the score of colon cleansing quality, the completion rate of colon capsule examination, lesion detection and adverse effects were observed. Chi-square test and Student′t test were used for statistical analysis. Results The whole gastrointestinal tract examination was completed during the capsule running time in 65.0% (26/40) of the patients. The average stomach transit time was (0.92±0.74) h, the small bowel transit time was (3.93±1.51) h and the colon transit time was (4.89±0.61) h. The capsule running time of patients who completed the whole gastrointestinal tract examination was shorter than that of patients who did not complete the whole gastrointestinal tract examination ((9.44 ± 3.53) h vs. (15.47±2.09) h), and the difference was statistically significant (t=6.79, P 0.05). A total of 33 (82.5%) patients had gastrointestinal lesions detected by colon capsule, including three cases of esophageal lesions (inflammation and mass), 21 cases of gastric lesions (chronic gastritis, mucosal protrusion, polyp and ulcer), nine cases of small bowel lesions (polyp, ulcer and vascular malformation) and 19 cases of colonic lesions (diverticulum, polyp, rectitis, mucosal erosion, ulcer and vascular malformation, internal hemorrhoids). Among them, there were 11 patients with two or more lesions. No adverse events occurred during the examination and all the capsules were excreted within 48 hours. Conclusion CCE-2 with high safety and good tolerance can be used for whole gastrointestinal tract examination. Key words: Second generation colon capsule endoscopy; Gastrointestinal examination; Colon cleansing quality; Safety
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