磁控胶囊胃镜在疑似上消化道出血老年患者中的诊断价值

Diagnostic value of magnetically controlled capsule gastroscope in elderly patients with suspected upper gastrointestinal bleeding

摘要:

目的 探讨磁控胶囊胃镜在疑似上消化道出血老年患者中的诊断价值。方法 纳入2020年10月至2022年9月宁夏医科大学总医院行磁控胶囊胃镜检查（magnetically controlled capsule gastroscopy，MCCG）的102例疑似上消化道出血患者，按年龄分为A组（≤65岁）38例和B组（>65岁）64例。分析两组患者的病例资料，检查前、中、后生命体征变化，病变检出情况及不良反应。结果 A组与B组患者的合并疾病差异有统计学意义。A组患者胃检查时间明显短于B组［（15.49±2.04）min比（16.61±2.02）min，t=-2.685，P=0.009］，小肠检查时间差异无统计学意义［（331.69±14.96）min比（337.83±14.28）min， t=-1.229，P=0.227］。A组患者不良反应发生率明显低于B组［0.00%（0/38）比6.25%（4/64），χ2=6.186，P=0.013）］。两组患者检查前、中、后生命体征的变化均无统计学意义。A组与B组患者上消化道病变检出率分别为92.1%（35/38）、98.4%（63/64），能解释上消化道出血的阳性率分别为60.0%（21/35）、50.8%（32/63）；不能解释上消化道出血的行小肠检查，小肠病变检出率分别为84.6%（11/13）、91.7%（22/24）。结论 磁控胶囊胃镜应用于疑似上消化道出血老年患者中的诊断价值较好，对于合并疾病多、高龄的上消化道出血患者安全性高也较适用（同时可完成小肠检查）。

Abstract:

Objective To investigate the diagnostic value of magnetically controlled capsule gastroscope in elderly patients with suspected upper gastrointestinal bleeding. Methods A total of 102 patients with suspected upper gastrointestinal bleeding who underwent magnetically controlled capsule gastroscopy (MCCG) in General Hospital of Ningxia Medical University from October 2020 to September 2022 were enrolled. Patients were divided into two groups according to age: 38 patients in group A (≤65 years old) and 64 patients in group B (> 65 years old). The case data, changes of vital signs, detection of lesions and adverse reactions of the two groups were compared. Results There were significant differences in combined diseases between group A and group B. The stomach examination time in group A was significantly shorter than that of group B (15.49±2.04 min VS 16.61±2.02 min, t=-2.685, P=0.009). There was significant difference in small intestine examination time between the two groups (331.69±14.96 min VS 337.83±14.28 min, t=-1.229, P=0.227). The incidence of adverse reactions in group A was significantly lower than that in group B [0.00%(0/38) VS 6.25%(4/64), χ2=6.186, P=0.013]. The changes of vital signs before, during and after examination were not statistically different. The detection rates of upper gastrointestinal lesions were 92.1% (35/38) and 98.4% (63/64), respectively. The positive rates of upper gastrointestinal bleeding under MCCG were 60.0% (21/35) and 50.8% (32/63), respectively. Patients with unexplained upper gastrointestinal bleeding under MCCG received small intestine examination. The detection rates of small intestinal lesions by small intestine examination were 84.6% (11/13) and 91.7% (22/24), respectively. Conclusion MCCG demonstrates excellent diagnostic accuracy in elderly patients with suspected upper gastrointestinal bleeding. Additionally, it is safe and suitable for use in elderly patients with multiple comorbidities, allowing for concurrent small intestine examination.