食管胶囊内镜与食管胃十二指肠内镜检查对门脉高压症的评价:一项性能和耐受性的前瞻性、对照研究

查看全文 作　　者：Lapalus M.-[1]G.;Dumortier J.;Fumex F.;纪泛扑 机构地区：[1]Fédération des Spécialités Digestives, Hpital Edouard Herriot, Pavillon H., 69437 Lyon Cedex 03, France Dr. 出　　处：《世界核心医学期刊文摘(胃肠病学分册)》索引2006年第2卷第5期,共2页 摘　　要：Background and study aims: Esophagogastroduodenoscopy (EGD) is the most effective method for examining the upper gastrointestinal tract, and particularly for evaluating portal hypertion cirrhotic patients, especially for screening purposes. The aim of this study was to assess the feasibility, safety, accuracy, and tolerance of PillCam ESO capsule endoscopy for this indication. Patients and methods: In this prospective study, unsedated EGD and capsule endoscopy examinations were conducted on the same day in cirrhotic patients at the time of diagnosis. The patients quantified the tolerability (relative to pain, nausea, choking sensations, etc.) of the two procedures using a 100 mm visual analogue scale. The time required for the recording and for diagnosis with the capsule examination were documented, as were the patients’ preferences in comparison with EGD. Two independent endoscopists blinded to the EGD diagnoses assessed the diagnostic accuracy of the images obtained. Results: Twenty-one patients were included in the study (mean age 62, mean Model for End-Stage Liver Disease score 10.5, mean Child-Pugh score 7.3). The procedure was safe. One patient was unable to swallow the capsule. The mean recording time was 213 s (range 6-1200 s); the procedure accurately assessed the presence or absence of esophageal varices in 16 of 19 patients (84.2 % ); and it correctly indicated a need for primary prophylaxis (esophageal varices of grade 2 or more and/or red signs) in 100 % of cases. The tolerability of the capsule endoscopy examination was significantly better, and all of the patients preferred capsule endoscopy to EGD (which was transnasal in 11 patients). Conclusions: Capsule endoscopy was feasible, safe, accurate, highly acceptable, and preferred by cirrhotic patients undergoing screening for portal hypertension. This new technique requires further and more extensive evaluation, as well as assessment of its cost-effectiveness. 关 键 词：胶囊内镜检查 门脉高压症 食管胃 耐受性 CHILD-PUGH评分 胃十二指肠 对照研究 肝硬化患者 食管静脉曲张 查对