| BackgroundCrohn's disease(Crohn 's diseases,the diagnosis of CD)there is no "gold standard",mainly based on clinical manifestations,performance under colonoscopy and biopsy or surgical pathology histology characteristics for diagnosis,and the need to rule out other possible related diseases,so for colonoscopy under performance is not obvious,biopsy or surgical pathology histology change no marked changes not clear diagnosis of suspected Crohn's disease diagnosis of Crohn's disease is hard,so need to know with the help of the other checks to colonoscopy and conventional imaging examination of small intestinal lesions may be difficult to find.Capsule endoscope(CE)has been used in recent years to examine the effect of small intestinal diseases and can also be used in patients with suspected Cohn's disease to understand the intestinal lesions.Small bowel CT imaging(computed tomography enterorrhaphy,CTE)and magnetic resonance small bowel imaging(magnetic resonance enterorrhaphy,MRE)check can also be used to understand the intestinal lesions,especially find bowel wall thickening,inflammation of the intestinal tract and the narrow lumen,a large number of studies have found that the CTE and MRE in intestinal disease inspection of specific and specific degrees are similar,so this study will be the two check equivalent.Capsule endoscopy and CTE(MRE)check the diagnostic value of the suspected Cohn's disease,also some scholars at home and abroad related research,but because our country has been gradually rising in recent years the incidence of Cohn's disease,and its incidence with race,regional differences,so still need further research,this study mainly check the two analysis for the diagnostic value of suspected Cohn's disease,in order to help clinical choice more diagnostic value.ObjectThis research mainly is capsule endoscopy and CTE(MRE)two checks for suspected Cohn's disease diagnostic value were analyzed,and the understanding to the two suspected crown disease examination revealed the lesion results with and without distinction,both for suspected Cohn's disease eventually have Cohn's disease diagnosis rate without distinction,what kind of inspection is more advantageous to suspicious Cohn's disease lesion characteristics of crown disease,in order to help clinical choice more diagnostic value examination,early diagnosis and early treatment of Cohn's disease,is important for the prognosis of crown disease.MethodsRetrospective analysis in January 2011 to December 2011 in the first affiliated hospital of Zhengzhou university digestive internal medicine during an all confirmed or suspected Crowns disease diagnosis in hospital medical records,collect the patient's general information,endoscopic examination,imaging examination,biopsy or surgical pathology information,further diagnosis and follow-up of patients situation,through the inpatient and outpatient medical records system with patient follow-up visit to understand and collect the patient's follow-up data,not by telephone follow-up visit,follow-up until December 2017.Results1.Collected medical records of 76 patients,according to the diagnosis and treatment of inflammatory bowel disease or less a consensus can be clear or 32 patients with diagnosis of Cohn's disease,not a definitive diagnosis in 44 cases of patients,eliminate,3 patients were lost to follow-up of suspected Crohn' disease total of 41 patients in this study.The average age of onset of the 32 patients diagnosed with Cohn's disease(38.50±16.61)and the ratio of male to female was 21:11.Suspected Cohn's disease of the average age of 41 patients(36.75±16.53),the sex ratio of male to female was 23:18.2.Capsule endoscopy examination of 18 patients with small intestinal lesions,16 cases(88.9%)found in according to the follow-up results of 14 cases of patients with the final diagnosis was Crohn's disease,87.5% of the total number of capsule endoscopy examination revealed small intestinal lesions,and the other 2 cases still for diagnosis of Crohn's disease.Two patients had no lesion detected by endoscopy in the small intestine,one of which excluded Crohn's disease,and the other one was suspected of Crohn's disease.3.CTE(MRE)check the 24 cases of 20 cases(83.3%)were found in patients with small intestinal lesions,according to the follow-up results of 7 cases of patients with the final diagnosis was Crohn's disease,accounting for CTE(MRE)inspection found that 35.0% of the total number of small intestine pathological changes,7 patients is still suspected diagnosis of Crohn's disease,6 patients out of Crohn's disease;4 cases of CTE(MRE)examination was found in 2 cases of small intestinal lesions in patients during the same period of hospitalization capsule endoscopy found small intestinal mucosal inflammatory lesion or ulcer,CTE(MRE)check the false negative rate was 50%.4.The endoscopic examination revealed 16 cases of small intestinal lesions,with a positive rate of 88.9%,and the diagnosis rate of Crohn's disease was 87.5%.The CTE(MRE)examination revealed 20 cases of small intestinal lesions,with a positive rate of 83.3%,and finally the diagnosis rate of Crohn's disease was 35%.According to the above result,capsule endoscopy and CTE(MRE)check for suspected Crohn's disease found that there was no statistically significant difference between the positive rate of small intestine lesion(P = 0.310),but Crohn's disease diagnosis rate of capsule endoscopy was obviously higher than that of CTE(MRE),difference was statistically significant(P = 0.002).5.There were 9 cases of patients separate do capsule endoscopy,8 cases(88.9%)of these patients were found small intestinal lesions,6 cases of separate do capsule endoscopy examination found that 75% of small intestinal lesions in number.There were 15 cases of patients separate do CTE(MRE),14 cases(93.3%)found in patients with small intestinal lesions,2 cases of separate do CTE(MRE)inspection found that 14.3% of the number of small intestinal lesions.According to the above result,capsule endoscopy and CTE(MRE)for suspected Crohn's disease found that there was no statistically significant difference between the positive rate of small intestine lesion(P = 0.489);The diagnostic rate of Crohn's disease alone was significantly higher than that of CTE(MRE)alone.Concludes1.By analyzing suspicious Crohn's disease line of capsule endoscopy and CTE(MRE)inspection found that the case of small intestinal lesions and follow-up of Crohn's disease diagnosis result,capsule endoscopy and CTE(MRE)for suspected Crohn's disease found that there was no statistically significant difference between the positive rate of small intestine lesion,but Crohn's disease diagnosis rate of capsule endoscopy was obviously higher than that of CTE(MRE).2.And by the same period of hospitalization and capsule endoscopy of CTE(MRE)two examination of patients with single line of capsule endoscopy in patients with comparing with the results of analysis,found that the former Crohn's disease diagnosis rate is higher than the single line of capsule endoscopy check,but the difference was not statistically significance.3.In addition,CTE(MRE)was found to have a higher false negative rate(50%)for patients with suspected Crohn's disease. |
PDF Full Text Request