Clinical Value Of Capsule Endoscopy In Small Intestinal Diseases

Objective:To explore the clinical value of capsule endoscopy in the diagnosis of small intestinal diseases,and to explore the predictive value of the clinical characteristics of patients to the positive detection results of capsule endoscopy,so that we can better use capsule endoscopy to guide the diagnosis of clinical diseases.Method:1.From June 2016 to April 2019,a retrospective analysis was carried out on the patients in the Department of Gastroenterology of Shanxi Provincial People's hospital.The clinical date of the patient's,such as age,gender,previous medical history,hemoglobin index,the type of capsule endoscopy,the results of capsule endoscopy,were collected.The clinical data such as microscopy results were used to calculate the detection rate and positive diagnosis rate of capsule endoscopy in small bowel diseases,and the predictive value of the clinical characteristics of the subjects to the positive detection results of capsule endoscopy was discussed.2.According the reasons for patients' capsule endoscopy,the patients were divided into the following three groups:(1)chronic abdominal pain: refers to the patients' clinical manifestations of abdominal pain lasting for more than six months,which is not clear after the improvement of general related examination to determine the cause of abdominal pain;(2)diarrhea: the duration is more than three months,and the number of defecation and defecation volume were significantly increased compared with the normal.(3)obcure gastrointestinal bleeding: it generally refers to the patients who can't determine the cause of continuous or repeated bleeding through routine endoscopy,small intestine CT,and other related auxiliary examinations.Results:1.In this study,194 patients using capsule endoscopy were included.After classification according to the purpose and clinical manifestations of the patients,including 68 patients(35.1%)with obcure gastrointestinal bleeding,104 patients(53.6%)with chronic abdominal pain,22 patients(11.3%)with diarrhea,115 males(59.3%)and79 females(40.7%),aged 15~83(56.6 ± 13.5)years old.2.The total detection rate of small intestine in patients with capsule endoscopy was53.6%(104 / 194),in which 66.2%(45 / 68)were patients with gastrointestinal bleeding,and the positive diagnosis rate was 55.9%(38 / 68),and the first 3 small intestine lesions were non-specific inflammation,small bowel ulcers and vascular malformations;53.8%(56/104)of patients with chronic abdominal pain,and a positive diagnosis rate of 41.4%(43/104),mainly non-specific inflammation,small bowel ulcers and Crohn's disease;chronic diarrhea The number of patients was 13.6%(3/22),and the positive diagnosis rate was 9.1%(2/22).It was mainly small bowel ulcers and non-specific inflammation.Compared with the patients with chronic abdominal pain,we found that there was no significant difference in the positive diagnosis rate of capsule endoscopy(55.9% vs41.4%,P > 0.05),which was significantly higher than that of patients with diarrhea(P <0.05).3.According to the analysis of the results of different types of capsule endoscopy,the total detection rate of small intestinal lesions in patients with domestic CE was 50.7%(38 / 75),the positive diagnosis rate was 40%(30 / 75);the total detection rate of small intestinal lesions in patients with imported CE was 54.7%(65 / 75),the positive diagnosis rate was 45.4%(54 / 119).By comparing the detection results of domestic and imported OMOM capsules with that of imported Pill Cam TM,there was no significant difference in the detection of small intestinal diseases between domestic and imported CE(P > 0.05).4.The detection rate of intestinal lesions in male patients was 58.3%(67 / 115),the positive diagnosis rate was 51.3%(59 / 115),and in female patients was 46.8%(37 / 79),the positive diagnosis rate was 31.6%(25 / 79).By analyzing the examination results,thepositive rate of capsule endoscopy was significantly lower in female patients than in males,and the difference was statistically significant(31.6% vs 51.3,P <0.05).5.Through logistic regression analysis,it was found that the gender and clinical manifestations of patients were related to the positive diagnosis results of capsule endoscopy(P < 0.05).Male and the clinical manifestations of gastrointestinal bleeding could be used as the predictive indicators of positive diagnosis of capsule endoscopy.Conclusion:1.Capsule endoscopy has great advantages in the detection of small intestinal diseases,especially in the use of patients with unknown gastrointestinal bleeding.2.The clinical data of male and gastrointestinal bleeding history can be used as a predictor of positive capsule endoscopic diagnosis.