系线的食管胶囊内镜诊断食管疾病的临床研究

发布时间：2018-02-09 02:54

本文关键词： 食管胶囊内镜食管疾病系线安全性诊断　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨系线的食管胶囊内镜检查食管疾病的安全性、可行性及其诊断价值。方法纳入2013年7月至2013年10月因有食管相关症状而就诊我院消化内科的80例患者，对食管胶囊内镜进行系线改良，先进行系线的食管胶囊内镜（SCE）联合实时监测系统检查，检查结束后半小时后行胃镜检查（EGD），对比分析2种检查的完成情况、食管疾病检出情况、不适症状及其并发症的发生情况。结果80例患者均完成2种检查，5例患者反复吞咽数次食管胶囊才进入食管。系线的食管胶囊内镜的食管检查平均耗时为（226.18±110.30）s，胃镜检查为（21.28±8.01）s。系线的食管胶囊内镜检查操作过程中，取出胶囊引起的不适评分最高，其次是线牵拉引起咽喉部不适及向上拉胶囊引起的不适；系线的食管胶囊内镜检查以轻度不适为主，占68.75%，其总体不适评分明显低于胃镜的总体不适评分（P＜0.05）。各不适症状评分上，，系线的食管胶囊内镜检查的吞服/插入困难、咽喉部不适、恶心、呕吐、胸骨后不适症状评分均小于胃镜检查，差异有统计学意义（P均＜0.05）；但胶囊检查发生咳嗽或呛咳的不适症状评分与胃镜检查比较差异无统计学意义（P＞0.05）。2种检查方法共检出74例119处食管黏膜病变，诊断食管病灶的符合率为82.35%(98/119)，其中5例局灶鳞状上皮高级别上皮内瘤变和3例食管早期鳞癌病灶（均被病理证实）均被两种检查检出。系线的食管胶囊内镜的食管疾病阳性检出率低于胃镜，但差异无统计学意义（87.5%比91.25%，P＞0.05）。以胃镜检查结果为标准，系线的食管胶囊内镜检出食管疾病的敏感性、特异性、阳性预测值和阴性预测值分别为94.52％、85.71％、97.18％和60.00％。1例患者于系线的食管胶囊内镜检查后出现牙龈出血，7例患者于胃镜检查后出现咽喉部出血。胃镜检查并发症总的发生率为8.75%（7/80），高于胶囊检查的1.25%（1/80）,且差异有统计学意义（χ2=4.238，P=0.040）。有91.30%（73/80）的患者更趋向于选择系线的食管胶囊内镜检查。如果需复查，87.50%（70/80）患者会选择系线的食管胶囊内镜检查。结论系线的食管胶囊内镜检查食管疾病操作简单、检查时间短、可重复利用、患者易耐受，诊断率较准确，且发生的不适症状、并发症均较胃镜检查小。它安全性、可行性好，可作为食管疾病诊断的一种较好的检查方法。
[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.

【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R571

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