本文關(guān)鍵詞： 食管膠囊內(nèi)鏡 食管疾病 系線 安全性 診斷　出處：《福建醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討系線的食管膠囊內(nèi)鏡檢查食管疾病的安全性、可行性及其診斷價(jià)值。 方法納入2013年7月至2013年10月因有食管相關(guān)癥狀而就診我院消化內(nèi)科的80例患者，對食管膠囊內(nèi)鏡進(jìn)行系線改良，先進(jìn)行系線的食管膠囊內(nèi)鏡（SCE）聯(lián)合實(shí)時(shí)監(jiān)測系統(tǒng)檢查，檢查結(jié)束后半小時(shí)后行胃鏡檢查（EGD），對比分析2種檢查的完成情況、食管疾病檢出情況、不適癥狀及其并發(fā)癥的發(fā)生情況。 結(jié)果80例患者均完成2種檢查，5例患者反復(fù)吞咽數(shù)次食管膠囊才進(jìn)入食管。系線的食管膠囊內(nèi)鏡的食管檢查平均耗時(shí)為（226.18±110.30）s，胃鏡檢查為（21.28±8.01）s。系線的食管膠囊內(nèi)鏡檢查操作過程中，取出膠囊引起的不適評分最高，其次是線牽拉引起咽喉部不適及向上拉膠囊引起的不適；系線的食管膠囊內(nèi)鏡檢查以輕度不適為主，占68.75%，其總體不適評分明顯低于胃鏡的總體不適評分（P＜0.05）。各不適癥狀評分上，，系線的食管膠囊內(nèi)鏡檢查的吞服/插入困難、咽喉部不適、惡心、嘔吐、胸骨后不適癥狀評分均小于胃鏡檢查，差異有統(tǒng)計(jì)學(xué)意義（P均＜0.05）；但膠囊檢查發(fā)生咳嗽或嗆咳的不適癥狀評分與胃鏡檢查比較差異無統(tǒng)計(jì)學(xué)意義（P＞0.05）。2種檢查方法共檢出74例119處食管黏膜病變，診斷食管病灶的符合率為82.35%(98/119)，其中5例局灶鱗狀上皮高級別上皮內(nèi)瘤變和3例食管早期鱗癌病灶（均被病理證實(shí)）均被兩種檢查檢出。系線的食管膠囊內(nèi)鏡的食管疾病陽性檢出率低于胃鏡，但差異無統(tǒng)計(jì)學(xué)意義（87.5%比91.25%，P＞0.05）。以胃鏡檢查結(jié)果為標(biāo)準(zhǔn)，系線的食管膠囊內(nèi)鏡檢出食管疾病的敏感性、特異性、陽性預(yù)測值和陰性預(yù)測值分別為94.52％、85.71％、97.18％和60.00％。1例患者于系線的食管膠囊內(nèi)鏡檢查后出現(xiàn)牙齦出血，7例患者于胃鏡檢查后出現(xiàn)咽喉部出血。胃鏡檢查并發(fā)癥總的發(fā)生率為8.75%（7/80），高于膠囊檢查的1.25%（1/80）,且差異有統(tǒng)計(jì)學(xué)意義（χ2=4.238，P=0.040）。有91.30%（73/80）的患者更趨向于選擇系線的食管膠囊內(nèi)鏡檢查。如果需復(fù)查，87.50%（70/80）患者會選擇系線的食管膠囊內(nèi)鏡檢查。 結(jié)論系線的食管膠囊內(nèi)鏡檢查食管疾病操作簡單、檢查時(shí)間短、可重復(fù)利用、患者易耐受，診斷率較準(zhǔn)確，且發(fā)生的不適癥狀、并發(fā)癥均較胃鏡檢查小。它安全性、可行性好，可作為食管疾病診斷的一種較好的檢查方法。
[Abstract]:Objective to investigate the safety, feasibility and diagnostic value of esophageal capsule endoscopy for the examination of esophageal diseases.
Methods included in July 2013 to October 2013 because of esophageal symptoms related to the digestive department of our hospital 80 cases of patients were improved on the line, esophageal capsule endoscopy, esophageal capsule endoscopy system first line (SCE) combined with real-time monitoring system of inspection, inspection of half an hour after the gastroscopy (EGD), a comparative analysis of the 2 inspection the completion situation of esophageal disease prevalence, occurrence of symptoms and complications.
Results all 80 patients completed the 2 examination, 5 cases of patients with recurrent dysphagia several times before entering the esophagus esophageal capsule. Esophageal capsule endoscopy of the esophagus check line average time for (226.18 + 110.30) s, gastroscopy is (21.28 + 8.01) s. line of esophageal capsule endoscopy during operation, remove the capsule caused the discomfort score was the highest, followed by the line of pull caused throat discomfort and cause discomfort to pull up the capsule endoscopy; line of esophageal capsule with mild discomfort, accounted for 68.75% of the total discomfort score was significantly lower than the overall score of gastroscope discomfort (P < 0.05). The discomfort the symptom score, endoscopic examination line esophageal capsule / insert swallowing difficulties, throat discomfort, nausea, vomiting, chest pain symptom scores were less than the gastroscopy, the difference was statistically significant (P < 0.05); but the capsule check occurs symptoms of cough or cough. There was no significant difference between score and gastroscopy (P > 0.05).2 methods were detected in 74 cases of 119 esophageal mucosal lesions, the diagnosis of esophageal lesions with the rate of 82.35% (98/119), including 5 cases of focal squamous intraepithelial neoplasia and 3 cases of early esophageal squamous cell carcinoma (lesions were pathological confirmed) were two detection. Esophageal capsule endoscopy line the esophageal disease positive rate is lower than that of gastroscopy, but the difference was not statistically significant (87.5% vs 91.25%, P < 0.05). The gastroscopy results as the standard, esophageal capsule endoscopy line detection sensitivity, esophagus disease specificity, positive predictive value and negative predictive value were 94.52%, 85.71%, and 97.18% 60.00%.1 patients in the Department of line of esophageal capsule endoscopy after bleeding gums, throat bleeding appeared in 7 patients. The incidence rate of gastroscopy after total gastroscopy complications 8.75% (7/80), higher than the 1.25% examinations (1/80), and the difference was statistically significant (2=4.238, P=0.040). 91.30% (73/80) endoscopy patients tend to choose the line of esophageal capsule. If need to review, 87.50% (70/80) endoscopy patients have line of esophageal capsule.
Conclusion the operation line of esophageal capsule endoscopy for esophageal diseases, inspection time is short, can be reused, the patient is easy tolerance, accurate diagnosis rate, symptoms and the complications were compared with gastroscopy. The safety, feasibility, a good inspection method can be used for the diagnosis of esophageal diseases.

【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R571

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相關(guān)期刊論文 前3條

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3 Ashish Shah;Erica Boettcher;Marianne Fahmy;Thomas Savides;Santiago Horgan;Garth R Jacobsen;Bryan J Sandler;Michael Sedrak;Denise Kalmaz;;Screening pre-bariatric surgery patients for esophageal disease with esophageal capsule endoscopy[J];World Journal of Gastroenterology;2013年37期

本文編號：1496901