【摘要】：目的回顧2012年12月—2016年7月在復(fù)旦大學(xué)附屬兒科醫(yī)院行膠囊內(nèi)鏡檢查的145例患兒的臨床資料,評價膠囊內(nèi)鏡檢查在兒童中的應(yīng)用和臨床價值。方法回顧性分析145例行膠囊內(nèi)鏡檢查患兒的一般資料和臨床資料,根據(jù)膠囊內(nèi)鏡工作記錄,分別統(tǒng)計無法吞服膠囊內(nèi)鏡需胃鏡輔助置入、自行吞入但仍需胃鏡輔助置入十二指腸和完全不需要胃鏡完成膠囊內(nèi)鏡檢查的患兒數(shù),膠囊內(nèi)鏡的總工作時間、胃通過時間、小腸通過時間,小腸病變檢出情況,觀察膠囊內(nèi)鏡檢查的安全性,同時分析炎癥性腸病(IBD)患兒中膠囊內(nèi)鏡和其他檢查的病變檢出情況。結(jié)果 145例中,男91例、女54例,平均年齡為(10.6±0.3)歲。無法吞服需胃鏡輔助下送入膠囊內(nèi)鏡者22例(15.2%),平均年齡為(8.3±0.8)歲;可自主吞服膠囊內(nèi)鏡者123例(84.8%),平均年齡為(11.0±0.3)歲。無法吞服膠囊內(nèi)鏡患兒的年齡顯著小于可自主吞服膠囊內(nèi)鏡的患兒(P0.000 1)。在可自主吞服膠囊內(nèi)鏡的123例患兒中,自主吞服膠囊內(nèi)鏡但需胃鏡輔助下置入十二指腸者64例(44.1%),平均年齡為(10.6±0.4)歲;完全不需要胃鏡完成膠囊內(nèi)鏡檢查者59例(40.7%),平均年齡為(11.5±0.3)歲�？勺灾魍谭z囊內(nèi)鏡的患兒中是否需要胃鏡輔助的患兒間年齡的差異無統(tǒng)計學(xué)意義(P0.05)。膠囊內(nèi)鏡平均總工作時間為(616.6±7.4)min,平均胃通過時間為(46.7±6.2)min,平均小腸通過時間為(291.9±10.6)min。Pearson相關(guān)性分析顯示,年齡與胃通過時間、小腸通過時間均無相關(guān)性(P值均0.05)。小腸病變檢出率為73.1%(106/145),病變類型主要為小腸潰瘍。51例IBD患兒中,新發(fā)IBD患兒36例,其膠囊內(nèi)鏡檢查、結(jié)腸鏡檢查、上下腹部增強CT檢查和小腸增強MRI檢查的小腸病變陽性發(fā)現(xiàn)率分別為100.0%(36/36)、91.7%(33/36)、78.1%(25/32)和86.4%(19/22);IBD復(fù)診患兒15例,其膠囊內(nèi)鏡檢查、結(jié)腸鏡檢查、上下腹部增強CT檢查和小腸增強MRI檢查的小腸病變陽性發(fā)現(xiàn)率分別為14/15、11/13、4/5和3/4。完成膠囊內(nèi)鏡檢查的患兒均在2周內(nèi)自主排出膠囊,未發(fā)現(xiàn)膠囊內(nèi)鏡滯留現(xiàn)象。結(jié)論膠囊內(nèi)鏡檢查是一種無創(chuàng)、安全、有效的小腸檢查手段,在兒童IBD的診斷和復(fù)發(fā)監(jiān)測中有較好的應(yīng)用價值,在某些小腸疾病的診斷中也發(fā)揮著其他檢查不能替代的作用,可以在兒科消化領(lǐng)域中推廣應(yīng)用。
[Abstract]:Objective to review the clinical data of 145 children who underwent capsule endoscopy from December 2012 to July 2016 in Pediatrics Hospital affiliated to Fudan University, and to evaluate the application and clinical value of capsule endoscopy in children. Methods the general data and clinical data of 145 children with capsule endoscopy were analyzed retrospectively. According to the working records of capsule endoscopy, it was calculated that the endoscopy could not be swallowed by gastroscope. The number of children who swallowed by themselves but still needed gastroscope to assist the implantation of duodenum and no need to complete capsule endoscopy, the total working time of capsule endoscopy, the time of gastric passage, and the detection of small intestinal lesions. To observe the safety of capsule endoscopy, and to analyze the detection of capsule endoscopy and other pathological changes in children with inflammatory bowel disease (IBD). Results among 145 patients, 91 were males and 54 were females, with an average age of (10.6 鹵0.3) years. 22 cases (15.2%) were unable to swallow capsule endoscopy, the average age was (8.3 鹵0.8) years old, 123 cases (84.8%) could swallow capsule endoscopy independently, the mean age was (11.0 鹵0.3) years. The age of children who could not swallow capsule endoscopy was significantly lower than that of patients who could swallow capsule endoscopy autonomously (P 0.000 1). Among 123 children who could autonomously swallow capsule endoscopy, 64 cases (44.1%) received endoscopy and the average age was (10.6 鹵0.4) years old, 59 cases (40.7%) had no need of endoscopy, the average age was (11.5 鹵0.3) years old. There was no significant difference in age between children who needed gastroscope in children who could swallow capsule endoscopy autonomously (P0.05). The average total working time of capsule endoscopy was (616.6 鹵7.4) min, the mean gastric transit time was (46.7 鹵6.2) min, the mean intestinal transit time was (291.9 鹵10.6) min.Pearson correlation analysis showed that there was no correlation between age and gastric transit time and intestinal transit time (P < 0. 05). The detection rate of small intestinal lesions was 73.1% (106 / 145). The main types of small bowel lesions were small intestinal ulcers. Among them, 36 cases were newly diagnosed as IBD, including capsule endoscopy and colonoscopy. The positive rates of enhanced CT and enhanced MRI were 100.0% (36 / 36) and 78.1% (25 / 32) and 86.4% (19 / 22), respectively. The positive rates of enhanced CT and enhanced MRI in upper and lower abdomen were 14 / 15 / 11 / 13 / 4 / 5 and 3 / 4 / 4 respectively. All the children who completed the capsule endoscopy excreted the capsule spontaneously within 2 weeks, and there was no phenomenon of capsule endoscopy retention. Conclusion capsule endoscopy is a noninvasive, safe and effective method for small bowel examination. It has a good application value in the diagnosis and recurrence monitoring of IBD in children, and plays an irreplaceable role in the diagnosis of some small bowel diseases. It can be widely used in the field of pediatric digestion.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院消化科;
【分類號】：R725.7

【參考文獻】

相關(guān)期刊論文 前3條

1 談濤;王寰;劉敏黎;劉海峰;;膠囊內(nèi)鏡患者臨床資料分析142例[J];中國內(nèi)鏡雜志;2016年05期

2 薄陸敏;廖專;徐燦;杜亦奇;郭杰芳;陳潔;張春華;方愛喬;楊麗;席慧君;吳仁培;李兆申;;1000例OMOM膠囊內(nèi)鏡檢查患者的回顧性分析研究[J];中華消化內(nèi)鏡雜志;2014年02期

3 Manari Oikawa-Kawamoto;Tsuyoshi Sogo;Takeshi Yamaguchi;Tomoyuki Tsunoda;Takeo Kondo;Haruki Komatsu;Ayano Inui;Tomoo Fujisawa;;Safety and utility of capsule endoscopy for infants and young children[J];World Journal of Gastroenterology;2013年45期

【共引文獻】

相關(guān)期刊論文 前10條

1 郜玉蘭;吳曉倩;郭磊磊;聶倩;;磁控膠囊內(nèi)鏡的疾病篩查應(yīng)用[J];中國內(nèi)鏡雜志;2017年07期

2 王勝楠;吳婕;黃瑛;;膠囊內(nèi)鏡檢查在145例患兒中的臨床應(yīng)用[J];上海醫(yī)學(xué);2017年05期

3 陳璇;陳紅莉;;莫沙必利在膠囊內(nèi)鏡檢查中的效果觀察[J];華夏醫(yī)學(xué);2017年03期

4 牛凌云;康艷;原麗莉;朱娜;任慶玲;張瑞;王青山;;不同促胃腸動力藥物對膠囊內(nèi)鏡檢查的影響[J];中國醫(yī)藥;2017年02期

5 李聯(lián)杰;尹合坤;李啟祥;吳海恩;;復(fù)方聚乙二醇序貫甘露醇改進膠囊內(nèi)鏡腸道準備[J];中國醫(yī)學(xué)創(chuàng)新;2017年02期

6 Dirk Bandorski;Niehls Kurniawan;Peter Baltes;Reinhard Hoeltgen;Matthias Hecker;Dominik Stunder;Martin Keuchel;;Contraindications for video capsule endoscopy[J];World Journal of Gastroenterology;2016年45期

7 張靖;楊燕敏;魏忠榮;陸建環(huán);楊檸娜;高麗;;膠囊內(nèi)鏡及小腸CT成像聯(lián)合檢查對小腸疾病的診斷價值[J];中國內(nèi)鏡雜志;2016年11期

8 蔡靜;宋麗;潘杰;周樂盈;俞海波;;膠囊內(nèi)鏡診斷不明原因消化道出血的價值[J];浙江實用醫(yī)學(xué);2016年05期

9 楊姍瑩;呂嬋;岑戎;;長期反復(fù)消化道出血小腸間質(zhì)瘤1例[J];胃腸病學(xué);2016年08期

10 李楠;陸恒;劉暢;吳琳;劉炯;汪芳裕;;573例膠囊內(nèi)鏡檢查回顧性分析[J];胃腸病學(xué);2016年08期

【二級參考文獻】

相關(guān)期刊論文 前7條

1 薄陸敏;楊俊馳;廖專;杜奕奇;陳潔;徐燦;楊麗;方愛喬;李兆申;;膠囊內(nèi)鏡滯留腸道的危險因素分析及預(yù)后隨訪[J];中華消化內(nèi)鏡雜志;2015年02期

2 薄陸敏;廖專;徐燦;杜亦奇;郭杰芳;陳潔;張春華;方愛喬;楊麗;席慧君;吳仁培;李兆申;;1000例OMOM膠囊內(nèi)鏡檢查患者的回顧性分析研究[J];中華消化內(nèi)鏡雜志;2014年02期

3 Xiu-Li Zhang;Zhong-Sheng Lu;Ping Tang;Jin-Yan Kong;Yun-Sheng Yang;;Current application situation of gastrointestinal endoscopy in China[J];World Journal of Gastroenterology;2013年19期

4 Mahesh Kumar Goenka;Shounak Majumder;Sanjeev Kumar;Pradeepta Kumar Sethy;Usha Goenka;;Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding[J];World Journal of Gastroenterology;2011年06期

5 周環(huán);張惠晶;汪旭;王軼淳;孫明軍;;70例膠囊內(nèi)鏡檢查的臨床應(yīng)用分析[J];中國內(nèi)鏡雜志;2011年01期

6 Raanan Shamir;Rami Eliakim;;Capsule endoscopy in pediatric patients[J];World Journal of Gastroenterology;2008年26期

7 王苑本;趙凱豐;鄭偉;;吸收不良綜合征病因發(fā)病機制及分類[J];世界華人消化雜志;2002年12期

【相似文獻】

相關(guān)期刊論文 前1條

1 戈之錚,陳海英,高云杰,胡運彪,蕭樹東;借助胃鏡完成小兒膠囊內(nèi)鏡檢查[J];中華消化內(nèi)鏡雜志;2005年04期

，

本文編號：2171431