【摘要】：目的比較回結腸鏡及小腸膠囊內(nèi)鏡在疑診克羅恩病中的診斷率,探討回結腸鏡及膠囊內(nèi)鏡在疑診克羅恩病診斷中的應用價值。方法回顧性分析疑診克羅恩病且先后行回結腸鏡及小腸膠囊內(nèi)鏡患者的臨床資料。計算并比較回結腸鏡、小腸膠囊內(nèi)鏡及兩種方法聯(lián)合運用的靈敏度與特異度。統(tǒng)計不同癥狀患者回結腸鏡及小腸膠囊內(nèi)鏡對克羅恩病的診斷率。結果共133例疑診克羅恩病患者納入本研究,隨訪發(fā)現(xiàn)16例確診為克羅恩病,117例排除克羅恩病�；亟Y腸鏡和小腸膠囊內(nèi)鏡及兩者聯(lián)合運用的靈敏度、特異度分別是回結腸鏡為81.25%、76.92%;小腸膠囊內(nèi)鏡為62.50%、92.31%;聯(lián)合運用為87.50%、73.50%。根據(jù)癥狀將患者分為腹痛組、腹瀉組、腹痛+腹瀉組,3組患者的回結腸鏡的診斷率分別為25.64%、32.79%、30.30%;小腸膠囊內(nèi)鏡的診斷率分別為10.26%、9.8%、27.27%。腹瀉組患者回結腸鏡較小腸膠囊內(nèi)鏡的診斷率高,差異有統(tǒng)計學意義(32.79%vs.9.8%,P=0.003)。結論回結腸鏡對克羅恩病的診斷靈敏度較高,可作為疑診克羅恩病的主要篩查方法。小腸膠囊內(nèi)鏡檢查陰性有助于排除克羅恩病�；亟Y腸鏡及小腸膠囊內(nèi)鏡對疑診克羅恩病的準確性均不高,克羅恩病的診斷不能僅憑回結腸鏡及小腸膠囊內(nèi)鏡等檢查結果,需要結合臨床表現(xiàn)、實驗室檢查、內(nèi)鏡及組織病理學結果進行綜合分析。
[Abstract]:Objective to compare the diagnostic rate of gynecoscopy and small intestine capsule endoscopy in suspected Crohn's disease and to explore the application value of gynecoscopy and capsule endoscopy in the diagnosis of suspected Crohn's disease. Methods the clinical data of patients with suspected Crohn's disease who underwent colonoscopy and small intestinal capsule endoscopy were retrospectively analyzed. The sensitivity and specificity of the two methods were calculated and compared. The diagnostic rate of Crohn's disease by colonoscopy and small intestinal capsule endoscopy was analyzed. Results A total of 133 suspected Crohn's disease patients were included in this study. 16 cases of Crohn's disease were diagnosed and 117 cases were excluded from Crohn's disease. The sensitivity and specificity of ileoculoscopy and intestinal capsule endoscopy and their combination were 81.25 and 76.92, 62.50 and 92.31, 87.50, 73.50 and 73.50, respectively. The sensitivity of ileoculoscopy and small intestinal capsule endoscopy was 87.50 and 73.50, respectively, and that of small intestinal capsule endoscopy was 62.50 and 92.31, and that of combined use was 87.50 and 73.50, respectively. According to the symptoms, the patients were divided into abdominal pain group, diarrhea group and abdominal pain diarrhea group. The diagnostic rates of the three groups were 25.64 and 32.79 and 30.30, respectively, and the diagnostic rates of small intestinal capsule endoscopy were 10.269.80.27.27 and 27.27, respectively. The diagnostic rate of colonoscopy in diarrhea group was higher than that in small intestinal capsule endoscopy (32.79 vs 9.8P 0.003). Conclusion the sensitivity of gynecoscopy in the diagnosis of Crohn's disease is high and can be used as the main screening method for suspected Crohn's disease. Intestinal capsule negative endoscopy helps to exclude Crohn's disease. The accuracy of gynecoscopy and small intestinal capsule endoscopy in suspected Crohn's disease was not high. The diagnosis of Crohn's disease should not be based on the results of ileoculoscopy and small intestinal capsule endoscopy, but should be combined with clinical manifestation and laboratory examination. The results of endoscopy and histopathology were analyzed.
【作者單位】： 南方醫(yī)科大學南方醫(yī)院消化內(nèi)科;
【分類號】：R574.62

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