Objective: To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint.
Methods: A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups.
Results: There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%).
Conclusions: Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.
目的: 评估胶囊内镜在以便血为主诉的小肠疾病患儿中的价值。
方法: 回顾性收集2015年5月至2019年1月复旦大学附属儿科医院收治的以便血为主诉且行胶囊内镜检查的93例患儿的临床资料及胶囊内镜检查结果，根据胶囊内镜检查结果（空肠及回肠段）分为阳性病变组（n=39）及阴性病变组（n=54），对两组的临床资料及胶囊内镜下的病变特征进行分析。
结果: 阳性病变组和阴性病变组患儿的年龄、性别、胶囊内镜检查时间、胃通过时间及小肠通过时间比较差异均无统计学意义（P > 0.05）。阳性病变组患儿的血红蛋白水平低于阴性病变组（P < 0.05）。血红蛋白值与胶囊内镜下阳性病变率呈负相关（r=-0.342，P=0.001）。胶囊内镜下发现有阳性病变的病例中，诊断为梅克尔憩室的比例最高（41%，16/39），其次为炎症性肠病（21%，8/39）。
结论: 胶囊内镜对下消化道出血患儿小肠疾病，特别是空肠及回肠段疾病的阳性检出具有一定价值。