The Diagnosis of Small Intestine Diseases by Wireless Capsule Endoscopy: A Multi Center Experience in Taiwan

以無線傳輸膠囊內視鏡診斷小腸疾病：臺灣多家醫學中心的經驗

洪志聖(Chih-Sheng Hung) ； 周仁偉(Jen-Wei Chou) ； 許文鴻(Wen-Hung Hsu) ； 陳丹霞(Tan-Hsia Chen) ； 許振銘(Chen-Ming Hsu) ； 徐以信(Yi-Hsin Hsu) ； 楊瑞能(Jui-Neng Yang) ； 盧俊良(Ching-Liang Lu) ； 李嘉龍(Chia-Long Lee)

《臺灣消化醫學雜誌》 29卷4期 (2012/12) Pp. 317-325

https://doi.org/10.6557/GJT.201212_29(4).0001

摘要

背景及目的：大約百分之五消化道出血無法經由胃鏡及大腸鏡檢查出出血位置。自2000年起，以無線傳輸訊號之膠囊內視鏡已應用於醫學診斷小腸病灶。這是一項台灣多醫學中心有關於以膠囊內視鏡診斷小腸病灶之回溯性研究。研究方法：這項回溯性研究是由問卷所完成。八家醫學中心共176位病患懷疑有小腸疾病且接受了膠囊內視鏡檢查。接受膠囊內視鏡檢查的原因為不明原因消化道出血、貧血、肚子痛、發炎性腸道疾病及胃類癌病史。這項由問卷完成的研究分析了膠囊內視鏡檢查下的病變、完成率、併發症及病患的預後。結果：膠囊內視鏡的小腸檢查完成率為66.9%。經膠囊內視鏡檢查小腸病灶診斷率為90.1% （155/172）。小腸血管畸形為最常好發之小腸病灶（47.7%, 82/172），其次為小腸息肉、小腸腫瘤（36%, 62/172） 及小腸潰瘍或糜爛（22.1%, 38/172）、小腸淋巴管弛張（14%, 24/172）等。二十位病患接受手術治療。另外十八位病患接受雙氣囊小腸鏡進一步檢查及治療。膠囊內視鏡滯留於小腸及大腸超過14天者有3位且最後都接受手術取出膠囊。結論：在這項研究中，膠囊內視鏡檢查研究報告與西方國家的統計結果並無明顯差異。膠囊內視鏡檢查不具侵襲性、有效而且安全，可用來當作第一線診斷小腸疾病的工具。

關鍵字

無線傳輸膠囊內視鏡 ； 小腸血管畸形 ； 膠囊內視鏡滯留

並列摘要

Backgrounds: 5% of gastrointestinal (GI) bleeding cannot be accurately detected by bi-directional endoscopy. Wireless capsule endoscopy (CE) was introduced into medical diagnosis since 2000. This study is a multicenter experience of CE to detect the small intestinal diseases in Taiwan.Materials and Methods: The retrospective study was completed by questionnaires. 176 patients underwent wireless capsule endoscopy in eight medical centers in Taiwan. The indications of CE were obscure GI tract bleeding (n=137, 77.8%), anemia (n=18, 10.2%), abdominal pain (n=18, 10.2%), inflammatory bowel disease history (n=2, 1.1%), and gastric carcinoid history (n=1, 0.6%). The study by questionnaires analyzed the pathologic findings, total completion rate, complications of CE and outcomes of patients.Results: The examination completion rate of CE was 66.9% (115/172) and diagnostic yield rate was 90.1% (155/172). Angiodysplasia was the most diagnosed disease (47.7%, 82/172) and followed by small intestinal polyps, tumors or submucosa tumors (36%, 62/172), small intestinal ulcers or erosions (22.1%, 38/172), lymphangiectasia (14.0%, 24/172). 20 patients received surgical treatments (11 with angiodysplasia, 9 with polyps or tumors) and 18 patients received double-balloon enteroscopic examination after CE. Three capsules (1.74%) retained in small and large intestine more than two weeks and removed by surgical treatment.Conclusions: This multicenter cases analysis presented similar results as Western's reports. Wireless capsule endoscopy is a non-invasive, effect and safe examination and can be used as first line tool to diagnose small intestinal diseases.

並列關鍵字

wireless capsule endoscopy ； small intestine angiodysplasia ； capsule retention