摘要
背景:胶囊内镜(CE)因无创性、直观性以及较高的检出率,已成为诊断不明原因消化道出血(OGIB)的一线方法。然而,无论CE检查结果是阳性或阴性,均无法准确预测患者是否会发生再出血。目的:初步探讨OGIB患者CE检查阳性或阴性后再出血的相关危险因素,以期降低再出血率。方法:选取苏州大学附属第一医院2009年10月-2013年10月行CE检查并有随访数据的OGIB患者116例,分析CE检查阳性或阴性患者的再出血率以及与再出血相关的危险因素。结果:CE诊断率为56.9%,总的再出血率为37.9%。CE检查阳性患者再出血率显著高于阴性患者(48.5%对24.0%,P<0.01)。男性、年龄≥50岁、高血压史、CE检查前3个月内累计出血量≥500 mL是CE检查阳性患者再出血率增加的独立危险因素,年龄≥50岁、凝血异常、未经特异性治疗是CE检查阴性患者再出血率增加的独立危险因素。结论:对于OGIB再出血高危患者,CE检查后应至少密切随访24个月;对于无危险因素的OGIB患者临床可避免重复检查。
Background ： Because of its non-invasiveness, direct inspection, and high detection rate, capsule endoscopy （CE） has been accepted as the first-line examination for diagnosis of obscure gastrointestinal bleeding （OGIB）. However, no matter the result of CE is positive or negative, it is unable to accurately predict the occurrence of rebleeding. Aims： To preliminarily investigate the related risk factors of rebleeding in OGIB patients with positive or negative CE for reducing the rebleeding rate. Methods： One hundred and sixteen OGIB patients undergone CE and with follow-up data from October 2009 to October 2013 at the First Affiliated Hospital of Soochow University were recruited, the rebleeding rate of patients with positive and negative CE, and the risk factors of rebleeding were analyzed. Results： CE diagnostic rate was 56.9%, and the overall rebleeding rate was 37.9%. The rebleeding rate in CE positive patients was significantly higher than that in CE negative patients （48.5% vs. 24.0%, P 〈 0.01）. Male, age ≥50 years, hypertension, accumulated bleeding ≥500 mL within 3 months before CE were the independent risk factors of increase in rebleeding rate in CE positive patients. Age ≥50 years, abnormal blood coagulation, without specific treatment were the independent risk factors of increase in rebleeding rate in CE negative patients. Conclusions： Followed-up should be performed in OGIB patients with risk factors of rebleeding for at least 24 months after CE. Repeated examination can be avoided in OGIB patients without risk factors.
出处
《胃肠病学》
2015年第8期462-466,共5页
Chinese Journal of Gastroenterology
关键词
不明原因消化道出血
胶囊内镜
危险因素
再出血
Obscure Gastrointestinal Bleeding
Capsule Endoscopy
Risk Factors
Rebleeding
