回结肠镜与小肠胶囊内镜在疑诊克罗恩病中的诊断价值

发布时间：2018-10-13 13:57

【摘要】：目的比较回结肠镜及小肠胶囊内镜在疑诊克罗恩病中的诊断率,探讨回结肠镜及胶囊内镜在疑诊克罗恩病诊断中的应用价值。方法回顾性分析疑诊克罗恩病且先后行回结肠镜及小肠胶囊内镜患者的临床资料。计算并比较回结肠镜、小肠胶囊内镜及两种方法联合运用的灵敏度与特异度。统计不同症状患者回结肠镜及小肠胶囊内镜对克罗恩病的诊断率。结果共133例疑诊克罗恩病患者纳入本研究,随访发现16例确诊为克罗恩病,117例排除克罗恩病。回结肠镜和小肠胶囊内镜及两者联合运用的灵敏度、特异度分别是回结肠镜为81.25%、76.92%;小肠胶囊内镜为62.50%、92.31%;联合运用为87.50%、73.50%。根据症状将患者分为腹痛组、腹泻组、腹痛+腹泻组,3组患者的回结肠镜的诊断率分别为25.64%、32.79%、30.30%;小肠胶囊内镜的诊断率分别为10.26%、9.8%、27.27%。腹泻组患者回结肠镜较小肠胶囊内镜的诊断率高,差异有统计学意义(32.79%vs.9.8%,P=0.003)。结论回结肠镜对克罗恩病的诊断灵敏度较高,可作为疑诊克罗恩病的主要筛查方法。小肠胶囊内镜检查阴性有助于排除克罗恩病。回结肠镜及小肠胶囊内镜对疑诊克罗恩病的准确性均不高,克罗恩病的诊断不能仅凭回结肠镜及小肠胶囊内镜等检查结果,需要结合临床表现、实验室检查、内镜及组织病理学结果进行综合分析。
[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.
【作者单位】：南方医科大学南方医院消化内科;
【分类号】：R574.62

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