| ObjectiveThe types of lesions detected by capsule endoscopy and detection rate in intestinal diseases were analyzed to evaluate the safety of capsule endoscopy in the application of small intestinal diseases,so as to explore the application value of capsule endoscopy in the diagnosis of small intestinal diseases.MethodsThis study retrospectively analyzed the clinical data of 171 patients(99 males and 72 females)who underwent Miro Cam capsule endoscopy in the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University from September 2017 to December 2019.The patients were divided into different groups based on different standards.1)According to the clinical symptoms,the patients were divided into the obscure gastrointestinal bleeding group(52 cases),the chronic abdominal pain group(63 cases),the chronic diarrhea group(37 cases)and other groups(19 cases);2)According to the age of the patients,they were divided into the elderly group(55 cases,60 yrs and older than 60 yrs)and the non-elderly group(116cases,younger than 60 yrs);3)According to the completion of capsule endoscopy in the small intestine,they were divided into the complete small intestinal transit group(154 cases)and the incomplete small intestinal transit group(17 cases).The transit time and complications of capsule endoscopy in the digestive tract were analyzed.The types of lesions in intestinal diseases by capsule endoscopy and detection rate ineach group were also analyzed,and furthermore,the detection rate of intestinal diseases by capsule endoscopy in each group and the diagnosis rate of etiology of capsule endoscopy in patients with different clinical symptoms were compared.The above data were analyzed using statistical software SPSS23.0.All measurement data were expressed as mean ± standard deviation or median(25th percentile ? 75 th percentile);The counting data were expressed as frequency(%).The non-normal distribution measurement data is tested by rank sum;The count data of rates is analyzed by chi-square test and continuous correction method was used when 1 < T?5(T is theoretical frequency).P < 0.05 was considered statistically significant.Result1.The transit time recorded by capsule endoscope in the digestive tract was as follows: the median total transit time was 720(719?720)min,the median gastric transit time was 28(12?71)min,and the median small intestinal transit time was 342(244?437)min.The median gastric transit time was 24(11? 65)min in the incomplete small intestinal transit group,and the median gastric transit time was 56(35? 172)min in the complete small intestinal transit group.The gastric transit time was significantly longer in patients of the incomplete small intestinal transit group than in those of complete small intestinal transit group(p < 0.01).2.The detection rate of small intestinal lesions was 73.7%(126 / 171)by the capsule endoscopy.The main types of small intestinal lesions detected by capsule endoscopy were inflammatory lesions,lymphatic dilatation and vascular lesions,followed by protuberant lesions,diverticulum,parasitic diseases and active small intestinal bleeding.3.Detection results in different groups with different clinical manifestations by capsule endoscopy.1)The detection rate of intestinal lesions in the obscure gastrointestinal bleeding group was 75.0%(39/52),the types of intestinal lesions detected by capsule endoscopy mainly were vascular lesions,lymphatic dilatation and inflammatory lesions.The diagnostic rate of etiology was 63.5%(33/52),the etiology mainly werevascular malformations and intestinal tumor.2)The detection rate of intestinal lesions in the chronic abdominal pain group was 76.2%(48/63),the types of intestinal lesions mainly were inflammatory lesions,lymphatic dilatation and vascular lesions.The diagnostic rate of etiology was 38.1%(24/63),the etiology mainly were intestinal inflammation and Crohn's disease.3)The detection rate of intestinal lesions in the chronic diarrhea group was73.0%(27/37),the types of intestinal lesions mainly were inflammatory lesions,lymphatic dilatation and vascular lesions.The diagnostic rate of etiology was 45.9%(17/37).the etiology mainly were intestinal inflammation and lymphatic dilatation.4)The detection rate of intestinal lesions in the other group was 63.2%(12/19),the types of intestinal lesions mainly were lymphatic dilatation,vascular lesions and inflammatory lesions.The diagnostic rate of etiology was 31.6%(6/19),the etiology mainly was vascular malformation.There was no difference in the detection rate between the four groups.The diagnostic rate of etiology in the obscure gastrointestinal bleeding group was higher than that in the chronic abdominal pain group(P < 0.0083).The remaining diagnostic rate of etiology had no statistical significance between the two groups.4.The detection rate of intestinal lesions in elderly group was 81.8%(45/55).The detection rate of intestinal lesions in non-elderly groups was 69.8%(81/116).There was no difference in the total detection rate of small intestinal lesions between the two group.The detection rate of vascular lesions in the elderly group was significantly higher than that in the non-elderly group(P < 0.01);The detection rate of lymphatic dilatation in the elderly group was higher than that in the non-elderly group(P < 0.05);The detection rate of inflammatory lesions in the non-elderly group was significantly higher than that in the elderly group(P < 0.05);There was no difference in the detection rate of protuberance lesions between the two group.5.The rate of incomplete small intestine examination was 9.9%(17 / 171).The rate of complete small intestine transit group was 74.7%,The rate of incomplete small intestine transit group was 64.7%.There was no difference in the detection rate oflesions between the two group.6.The complication rate of capsule endoscopy was 1.8%.ConclusionCapsule endoscopy can effectively detect small intestinal lesions in patients with different clinical symptoms and different ages,and also has the characteristics of low complications and good tolerance of patients.It has a high application value in the diagnosis and differential diagnosis of small intestinal diseases. |
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