论文部分内容阅读
目的探讨胶囊内镜(CE)、小肠CT成像(CTE)及气钡双重造影(DCBE)对不明原因消化道出血(OGIB)的诊断价值。方法回顾性分析2011年9月至2015年5月在该院诊治的86例OGIB患者的临床资料。其中行CE检查37例(CE组),行CTE检查35例(CTE组),行DCBE检查14例(同时行CE和CTE联合检查,DCBE组)。对三组患者的病变发生率及诊断符合率进行比较,探讨CE、CTE及DCBE对OGIB的诊断价值。结果 CE组中,发现小肠阳性病变30例,漏诊3例,误诊1例,病变检出率为81.1%(30/37),诊断符合率为87.9%(29/33)。行CTE组中,发现小肠阳性病变24例,漏诊4例,误诊1例,病变检出率为68.6%(24/35),诊断符合率为82.1%(23/28)。DCBE组中,发现小肠阳性病变6例,漏诊7例,病变检出率为42.9%(6/14),诊断符合率为46.2%(6/13)。DCBE、CE组病变检出率比较,差异有统计学意义(P<0.05);DCBE组病变检出率及诊断符合率明显低于CE、CTE组,差异均有统计学意义(P<0.05)。结论在OGIB的诊断中,CE和CT小肠成像均具有较高的诊断价值,可作为OGIB的主要检查手段;DCBE诊断价值较低,可选择性使用。
Objective To investigate the diagnostic value of capsule endoscopy (CE), small intestine CT (CTE) and barium double contrast (DCBE) in the diagnosis of unexplained gastrointestinal bleeding (OGIB). Methods The clinical data of 86 OGIB patients diagnosed and treated in our hospital from September 2011 to May 2015 were retrospectively analyzed. CE was performed in 37 cases (CE group), CTE in 35 cases (CTE group) and DCBE in 14 cases (concurrent CE and CTE, DCBE group). The incidence of the three groups of patients and diagnosis of coincidence rate were compared to explore the CE, CTE and DCBE OGIB diagnostic value. Results In the CE group, 30 cases of small intestinal positive lesions were found, 3 cases were misdiagnosed and 1 case was misdiagnosed. The detection rate of lesions was 81.1% (30/37). The diagnostic coincidence rate was 87.9% (29/33). In the CTE group, 24 cases of small intestine positive lesions, 4 cases of missed diagnosis and 1 case of misdiagnosis were found. The detection rate of lesions was 68.6% (24/35). The diagnostic coincidence rate was 82.1% (23/28). In the DCBE group, 6 cases of small intestinal positive lesions and 7 cases of missed diagnosis were found. The detection rate of lesions was 42.9% (6/14). The diagnostic coincidence rate was 46.2% (6/13). The detection rate of DCBE and CE was significantly lower than that of CE and CTE (P <0.05), and the difference was statistically significant (P <0.05) . Conclusion In the diagnosis of OGIB, CE and CT small bowel imaging have high diagnostic value, which can be used as the main examination means of OGIB. The diagnostic value of DCBE is lower and can be selectively used.