胶囊内镜在儿童胃肠道疾病中的应用及诊断价值分析

Application and diagnostic value of capsule endoscopy in children with gastrointestinal diseases

摘要:

目的 探讨胶囊内镜在儿童胃肠道疾病中的应用价值。方法 回顾性分析2021年1月至2023年12月首都医科大学附属首都儿童医学中心消化内科行胶囊内镜检查患儿的临床资料，分析镜下病变检出情况、胶囊内镜应用方式和胶囊内镜在消化道各部位运行时间等。结果 共纳入490例患儿，年龄10.75（7.94，12.83）岁，其中最小应用年龄为1岁3个月，最低应用体重为8.5 kg。128例（26.1%）自行吞入胶囊内镜，362例（73.9%）胶囊内镜通过胃镜送入十二指肠。478例（97.6%）患儿完成全小肠检查。胶囊内镜在小肠内的运行时间为368.5（253.3，493.8）min。2例（0.4%）发生胶囊滞留。胶囊内镜总体病变检出率为33.5%（164/490）。年龄7岁组检出病变40例，检出率为42.1%（40/95）；≥7岁组检出病变124例，检出率为31.4%（124/395）。7岁组病变检出率高于≥7岁组（χ2=3.947，P=0.047）。结论 胶囊内镜在儿童胃肠道病变检查中有一定的病变检出率，全小肠检查完成度高，胶囊滞留发生率低，具有临床应用价值。年龄小于7岁儿童病变检出率高于7岁及以上儿童。通过胃镜将胶囊内镜送入十二指肠的检查方式解决了低龄儿童吞咽困难的问题，为更多儿童提供了检查机会。

Abstract:

Objective To explore the application value of capsule endoscopy for gastrointestinal diseases in children. Methods Clinical data of children who underwent capsule endoscopy at the Department of Gastroenterology, Capital Center For Children''s Health, Capital Medical University from January 2021 to December 2023 were retrospectively analyzed. Lesion detection rates, capsule placement methods, and capsule transit times through different segments of the digestive tract were analyzed. Results A total of 490 children were included, with the age of 10.75 (7.94, 12.83) years. The youngest age was 1 year and 3 months, and the lowest body weight was 8.5 kg. Among them, 128 (26.1%) swallowed capsule endoscope independently, while 362 (73.9%) required endoscopic delivery of the capsule to the duodenum. Total small-bowel transit was completed in 478 cases (97.6%). The small-bowel transit time was 368.5 (253.3, 493.8) minutes. Capsule retention occurred in 2 cases (0.4%). The overall lesion detection rate of children''s digestive system diseases was 33.5% (164/490). The detection rate of lesions in the group under 7 years of age was higher than in those aged 7 years or older [42.1% (40/95) VS 31.4% (124/395), χ2=3.947, P=0.047]. Conclusion Capsule endoscopy offers a meaningful lesion detection rate in pediatric gastrointestinal evaluation, with a high rate of complete small-bowel examination and a low capsule retention rate, supporting its clinical utility. Lesion detection is higher in children under 7 years of age compared with older children. Endoscopic placement of the capsule into the duodenum effectively overcomes swallowing difficulties in young children, thereby expanding the applicability of this examination.