OMOM 胶囊内镜对不明原因腹痛的诊断作用.pdf

nullnullOMOM5=yeT张null洁,王邦茂,张庆瑜,林null睿,朴美玉,常毅湘(?DSv9DhS,?300052)nullnullKnull1:null了解国产OMOM胶囊内镜在慢性腹痛中对小肠疾病的临床诊断应用价值bZEnull2008年2月至2010年1月间,应用OMOM胶囊内镜(重庆金山科技集团生产)对67例慢性腹痛患者(腹痛组)和46例无任何症状的查体者(查体组)进行检查,其中腹痛组患者均过经多次胃镜和结肠镜检查,未发现可以解释慢性腹痛的病变bTnull慢性腹痛组患者中小肠黏膜病变的诊断阳性率为68.7%(46/67),明显高于健康查体人群的21.7%(10/46)；腹痛组46例小肠黏膜病变中以小肠黏膜非特异性炎症为最多,占21例,其次为小肠单发或者多发的息肉12例；回肠和空肠单发或多发的小溃疡11例,结合临床病史诊断为小肠克罗恩病；小肠肿瘤6例；小肠未发现任何异常的占25.7%(17/67),小肠淋巴组织增生11例b腹痛组患者OMOM胶囊在小肠的通过时间(243.961.9)min明显长于查体组(215.352.9)min(P0.05)bnull国产OMOM胶囊内镜对小肠黏膜病变的诊断阳性率高,而且安全无痛苦,具有较好的临床应用价值,尤其适用于不明原因的慢性腹痛患者b1oM:肠疾病；腹痛；胶囊内镜；诊断ms|:R574nullDSM:AnullcI|:1004null583X(2010)14null1205null05OMOMcapsuleendoscopyindiagnosisofunexplainedabdominalpainZHANGJie,WANGBangnullmao,ZHANGQingnullyu,LINRui,PIAOMeinullyu,CHANGYinullxiangDepartmentofGastroenterology,TianjinMedicalUniversityGeneralHospital,Tianjin300052,ChinaABSTRACT:ObjectivenullTounderstandthedomesticOMOMcapsuleendoscopyinpatientswithchronicabdominalpainofintestinaldiseasesintheclinicaldiagnosticvalue.MethodsnullFeb.2008nullJan.2010,theOMOMcapsuleendoscopyproducedbyChongqingJinshanScienceandTechnologyGroupwasusedin67patientswithchronicabdominalpain(namedabdominalpaingroup)and46personswithoutanysymptoms(namedhealthypeoplegroup).Allthepatientswithchronicabdominalpainhadbeenexaminedwithrepeatedgastroscopyandcolonoscopy,butwerenotfoundthecausesfortheabdominalpain.ResultsnullForsmallintestinalmucosainabdominalpaingroup,thediagnosticpositiveratewas68.7%(46/67),significantlyhigherthanthatinhealthypeoplegroup21.7%(10/46)；about21casessufferedfromnonnullspecificinflammationofthesmallintestineinthe46patientswithsmallintestinallesionsintheabdominalpaingroup,thenfollowedbysingleormultiplesmallbowelpolypsin12cases.Ileumandjejunumsingleormultiplesmallulcersin11cases,withtheclinicalhistories,theywerediagnosedsmallbowelCrohndisease.Smallintestinaltumoroccurredin6cases.About25.7%(17/67)patientsintheabdominalpaingroupshowedabsolutelynormalsmallintestinewhereas11caseswereintestinallymphoidhyperplasia.Inabdominalpainpatients,OMOMcapsuletransittimeinthesmallintestine(243.961.9)minwassignificantlylongerinhealthypeoplegroup(215.352.9)min(P0.05).ConclusionnullDomesticOMOMcapsuleendoscopyforsmallintestinallesionshashigherpositiverate,andmoresecuritywithoutthepain,andithasgoodclinicalvalue,especiallyforpatientswithunexplainedchronicabdominalpain.KEYWORDS:intestinaldisease；abdominalpain；capsuleendoscopy；diagnosisnullnullyeh,H?H/e,hV6B%h1behy,4bB,eKn%,/ehM8=%hn,l%hhqM2,9BsVa8CT_(nsf,wV?l*hMbl3.357.85m,g8,8?,h=_u3b1V2001M5SwainIddannull1205null!5$Ynull2010M7202514nullClinicalFocus,July20,2010,Vol25,No.145=gg,AlVj_b4bA4l%h_q,S7,n,?Wb2008MiOMOM?5=,P5=yehy_b1nullZE1.1nullnull2008M22010M1ye67(eF),339,o28,M-1985,(55.916.9),(V2Q2Q0aal/abCT_,(?CVd5VChMb846(8F),rB88_,326,o20,M-1274,(46.314.2)bs_S:M-V10,3oK,Q?Ta/.e,.eW?Te,Vaal/ahTCTaU7m_(?ChM,685bS:#J5.N4VPlEai；#r0D!；%*haw?1e；&Xp；Sm5b1.2nullZE1.2.1null_ZEnulls_-J8lH,igZY=?135g2000mlA,b!,s_-,vL810Q,bLbvOMOM5=T?|L,z:cN,5=h,Hq,5lH=,5SX,/51,V；5L,50.51lHW,OMOM5LHS,45XYVl,TV1lH,5l,T,3|5wE=,5?l*_:cb_V-2lH,-4lHJ,7VJJb_,|:cN/OMOMT_,2hS=D=sYmsb1.2.2nullNnulliOMOM?5=msd,d?0.1mmvl4v,j140P,j3mm,2mv,?VT8lH,1_Vv_:cN.6mb1.2.3null4Snull#OMOM5$_alYVHW8HW；5=*hM?C；%S5=_b1.3nulld9ZEnullSPSS13.0d9q),9(S(nullxs)VU,F!9t_；9sVU,null2_#MqE_,P0.05sd9ilb2nullnullT2.1null5=HWnullOMOM5vl1.3cm(2.8cm,150v,s_,M8aHW5OMOM5(4,50.5lH1QOMOM_dLHS,5XYVE=8,475aLe,V3Q5=LHS,?C51.5lH,5=g,/YV3|5wVgE=8,eF27?5h,15h=8=beF5hYVHW8HWsY18F1,s(d9il；eFOMOM5lYVHWA8F(P0.050.052.2null5=?Ca*hMnull67eF46l*hM,l*hMq68.7%,l/ab_ZEl%h_q(40.0%P),HArB8null1206null!5$Ynull2010M7202514nullClinicalFocus,July20,2010,Vol25,No.1421.7%(P0.05)；eFl*?Cs25.7%,l%F9311(m1)beF*hq38.8%,A8F60.9%(P0.050.050.050.050.01FY*hMMh*hM22hMeF6726(38.8)8(11.9)6(8.9)1(1.5)12(17.9)36(53.7)8F4628(60.9)6(13.0)2(4.3)0nullnull7(15.2)19(41.3)null25.3210.0310.8800.6930.1411.686P0.050.050.050.050.052.3null5=al*hMnulleF46l*hMl*d+sK,VCl)1*?,5A；Ql?12,vlV1.0cm,V；,(m2)；b?l11,0.20.5cmW,V$,*?,5hNlX6h(m3)；lvH6,l81/2,VSmlhLlW?l?(m4)；_*hM26,1*?,al(m5)；325YV,5ivs*A,5Ah,iOAYj74,yN?C8l,6Mh,186；2Q8_,!4D4y,(r,5_?C5YV20cm),n1E582/3vH,Vaa?,5YVE,N=HW,?,mL(m6),NHMhlbN,Hial22hM36,eF53.7%；8Fl*47.8%ns,7(15.2%)l%F93；Ql*d+sl*ll；8F_*hM28；_Mh,Hi22hM19(41.3%)b2.4nullOMOM5=TQnull5=THW326513s,(THW357s,(|v63542f,s_(?_,=8=?f,LM5=_H?CMh,_,a0,9y5,3?n5s_,_,58=bS5=9FLHSed,H4,5bs_5=4,_VaQbOMOM5=mVQ9k,Xr30sOq,_D=4AmHX$b,M2A5=AuYbmdTrqA4,/mHWg56lHP4C20s,A4D3Trq,_；OMOM5=_d(,M4,_V1,9Y5=lYVHW4b3null)nullhS,ye1nB%h,4bvXYV08_,*hM,l+y,null1207null!5$Ynull2010M7202514nullClinicalFocus,July20,2010,Vol25,No.148W,v,Pl%h_Md4bl4/aDSA5/aCT#A_,W,Yy,qbwTl?4sl,?l%h,7O_Hemv,1eHq/,iOa,daJiB6b?Given5=W,SOMOM5=9VleVj_,1)S5=ea8rTb5=blYVHW:S5=VVASB3V,4s_fbM2A5=?40,bHWlYVHWA7,765B5=?40YVHWM,75=Bs8=,4UNV?ihM|8belYVHWA8F,788HW,Fsd9il,N9TMB,4UlVPbHW,i,=#*Q,V?yeBhy2,N,5Bt9h0,Bse；6,eFlYVHW8F,V?9sF1,eFM-v,C5L,78FM,z,Wei10M-YHW1b5=yel*hMq:eFl*hM_q68.7%,5F4gM2A5=l*h_q(65.2%)B5,S5=l*hM4rTg5=bl*hM9l*Kn,Ql?l,wl*,V?lueKnybRondonotti11Eliakim12YV7M,5=yhqK,Ql*?,ehyqh,V?%hHl*hMSA1b58F?Cl*5(10.9%),7eFl*12(17.9%),Wsd9il,4Ue*e112b8VBl/?M,1$ezbe17,5=_l*nsl*%F9311,7l*%F93lF,tsgAhM,V?e,VM0beF6_l*,iOVlSmLl0?b4l?hq,v?1%3%,Trifan134V5=_102,?C5(4.9%)l,X$5lSmL,N,5=l?zNb,l?_qr8.9%(6/67),SMB,9A.dq,iOTrifan13,V?4h1,yN,5=l*hMzrTb5=rB8:5=SVj,7=_/,daM8ak?0s08_,Hi57_8b8F,55,t?C*hM:*,H,E=；*Mh?l；l*d+s,4Ut1SB_,y5=8l,8=?Te7byN*hM_,*4,5=8=,5=byN,5=T8PlhMH,%hbOMOM5=K:S5=1.3cm(2.8cmvlM2Ag5=(1.1cm(2.6cm)+M+,:cmbnull1208null!5$Ynull2010M7202514nullClinicalFocus,July20,2010,Vol25,No.14M2A5=M_,/Ag5=,Ng5=2/3P,yN,OMOM5=T?Xg5=,.,gM2A5=1,9LHSe?,VHs_Se,45=8=,?5=Xl,A1Hm|5=wE=8,l*_bVTrB8BZEbOMOM5=_d(,Bb5=lj7_BS/m,?1%,ye1l/aCT_ZEqA4,7OwTl_emQ,v|l%h_nZEb55=d,iBtK,5=Ve,?9hM_；5=_hM,?4,7?F_,iO5S5=1gM2A/,8_n,B?Zb,5=5,l%h_,+Yyehy7-b(mn)ID:1nulla.hM.Z:ZS/,2001:155.2nullFryLC,CareyEJ,ShiffAD,etal.TheyieldofcapsuleendoscopyinpatientswithabdominalpainordiarrheaJ.Endoscopy,2006,38(5):498null502.3nullMazzaroloS,BradyP.Smallbowelcapsuleendoscopy:asystematicreviewJ.SouthMedJ,2007,100(3):274null280.4nullIddanG,MeronG,GlukhovskyA,etal.WirelesscapsuleendoscopyJ.Nature,2000,405:(6785)417.5nullf,.5=h%hJ.h=,2007,6(24):172null176.6null,g,2f.5=5ZJ.Wh,2008,16(36):4081null4087.7nullXinW,YanG,WangW.StudyofawirelesspowertransmissionsystemforanactivecapsuleendoscopeJ.IntJMedRobot,2010,6(1):113null122.8nullCaddyGR,MoranL,ChongAKetal.TheeffectoferythromycinonvideocapsuleendoscopyintestinalnulltransittimeJ.GastrointestinalEndoscopy,2006,63(2):262null266.9nullN,.5=eNJ.S=,2008,(8):867null872.10nullWeiW,GeZZ,GaoYJ,etal.EffectofmosaprideongastrointestinaltransitnulltimeanddiagnosticyieldofcapsuleendoscopyJ.JGastroentrolHepatal,2007,22(10):1605null1608.11nullRondonottiE,SonciniM,GirelliC,etal.Smallbowelcapsuleendoscopyinclinicalpractice:amulticenter7nullyearsurveyJ.EurJGastroenterolHepatol,2010,18.Epubaheadofprint12nullEliakimR.VideocapsuleendoscopyofthesmallbowelJ.CurrOpinGastroenterol,2008,24(2):159null163.13nullTrifanA,SingeapAm,CojocariuC,etal.Smallboweltumorsinpatientsundergoingcapsuleendoscopy:asinglecenterexperienceJ.JGastrointestinLiverDis,2010,19(1):21null25.l:2010null05null28null:2010null06null02nullI:姜恒丽(上接第1204页)10nullj,vB,f,.8i%h5J.D,2006,86(30):2114null2116.11nullWassinkAM,vanderGraafY,OlijhoekJK,etal.Metabolicsyndromeandtheriskofnewvasculareventsandallnullcausemortalityinpatientswithcoronaryarterydisease,cerebrovasculardisease,peripheralarterialdiseaseorabdominalaorticaneurysmJ.EurHeartJ,2008,29(2):213null223.12nullVuJD,VuJB,PioJR,etal.ImpactofCnullreactiveproteinonthelikelihoodofperipheralarterialdiseaseinUnitedStatesadultswiththemetabolicsyndrome,diabetesmellitus,andpreexistingcardiovasculardiseaseJ.AmJCardiol,2005,96(5):655null658.13nullHolewijnS,denHeijerM,SwinkelsDW,etal.ThemetabolicsyndromeanditstraitsasriskfactorsforsubclinicalatherosclerosisJ.JClinEndocrinolMetab,2009,94(8):2893null2899.14nullLnullpeznullSunullrezA,BeltrnullnnullRoblesM,ElviranullGonznulllezJ,etal.DoesdiagnosisofmetabolicsyndromepredictthelikelihoodofperipheralarterialdiseaseasdefinedbyalowanklenullbrachialindexJ.EurJCardiovascPrevandRehabil,2008,15(6):693null697.15nullLahozC,VicenteI,LagunaF,etal.Metabolicsyndromeandasymptomaticperipheralarterydiseaseinsubjectsover60yearsofageJ.DiabetesCare,2006,29(1):148null150.16null