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胶囊内镜在克罗恩病患者中的应用：诊断价值及安全性
Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety
Mehdizadeh S, Chen GC, Barkodar L  2010/7/9 14:05:06 
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Gastrointest Endosc, 2010,
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Background:
Capsule endoscopy (CE) is increasingly used in patients with suspected or known Crohn's disease (CD).

Objective:
To determine the diagnostic yield of CE and the distribution of small-bowel (SB) lesions in symptomatic patients with known CD.

Design and Setting:
Retrospective review of CE procedures performed in patients with CD between 2001 and 2005 in a tertiary care center.

Patients:
One hundred thirty-four patients with an established diagnosis of CD and symptoms suggestive of active disease.

Interventions:
Swallowing the capsule.

Main Outcome Measurements:
Diagnostic yield of CE and distribution of SB lesions in patients with CD.

Results:
One hundred forty-six CE procedures were performed on 134 CD patients. Fifty-two (39%) of 134 patients had CE findings diagnostic of active CD (>3 ulcerations), and 17 (13%) had findings suggestive of active CD (≤3 ulcerations). Fifty-seven (42%) patients had normal findings, and 6% had normal but incomplete studies. The distribution of SB lesions was 32% in the duodenum, 53% in the jejunum, 67% in the proximal ileum, and 85% in the distal ileum. CE was comparable to ileoscopy in detecting ileal ulcerations (55% vs 48%), but superior to SB follow-through in detecting CD lesions in the SB (incremental yield of 32%; 95% CI, 9%-54%; P=.0017).

Limitations:
Retrospective study from a single center.

Conclusions:
CE identified SB lesions in approximately half of symptomatic CD patients. Large-scale prospective studies are needed to evaluate whether positive CE findings may affect disease outcomes.
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