儿童磁控胶囊内镜小肠检查完成情况及影响因素分析（附601例报告）

Completion rate and influencing factors of magnetically controlled capsule endoscopy for small bowel evaluation in children: a retrospective analysis of 601 cases

摘要:

目的 该研究旨在评估儿童小肠磁控胶囊内镜（MCCE）检查的完成情况及其影响因素。方法 回顾性分析601例接受小肠MCCE检查的患儿的临床资料，观察检查成功率、病变检出率、小肠通过时间（SBTT）和检查完成情况等，并分析影响因素。结果 主要表现为：腹痛（62.7%）、腹泻（10.0%）、发热（4.0%）、贫血（3.8%）和便血（3.5%）。483例患儿可自主吞咽胶囊，8例经手法辅助送服，110例经胃镜置入；小肠检查成功率为95.7%，SBTT为302.00（217.00，464.35）min。共检出小肠疾病290例（48.3%），以非特异性小肠炎、克罗恩病、小肠息肉和过敏性紫癜为主。克罗恩病和非特异性小肠炎多见于学龄期儿童和青少年，以男孩居多；小肠息肉和过敏性紫癜多见于学龄期儿童，前者以女孩居多，后者以男孩居多。常见内镜表现为：炎症（75.9%）、淋巴滤泡增生（56.6%）、溃疡（34.8%）和糜烂（25.5%）。SBTT与镇静状态呈明显正相关（r = 0.527，P = 0.000），小肠检查完成情况与镇静状态、胃-十二指肠反流、胃转运时间和SBTT存在相关性（P 0.05），但相关系数均较小。结论 MCCE用于儿童小肠疾病的诊断安全、可行，病变检出率高，镇静可延长SBTT，但对检查完成率影响较小。

Abstract:

Objective To investigate the completion rate and influencing factors of magnetically controlled capsule endoscopy (MCCE) for small bowel evaluation in children.Methods Clinical data of 601 children receiving MCCE were retrospectively analyzed. Primary outcomes included examination success rate, lesion detection rate, small bowel transit time (SBTT), and examination completion status. Correlative factors were statistically analyzed.Results The top clinical manifestations were abdominal pain (62.7%), diarrhea (10.0%), fever (4.0%), anemia (3.8%), and hematochezia (3.5%). A total of 483 children swallowed the capsule independently, 8 received manual assisted administration, and 110 required endoscopic capsule placement. The overall small bowel examination success rate was 95.7%, with a median SBTT of 302.00 (217.00, 464.35) min. Small bowel lesions were detected in 290 patients (48.3%), dominated by non-specific enteritis, Crohn’s disease, small intestinal polyps, and Henoch-Sch?nlein purpura. Crohn’s disease and non-specific enteritis were predominant in school-age children and adolescents (male predominance); small bowel polyps were more common in school-age girls, while Henoch-Sch?nlein purpura was more frequent in boys. The most common endoscopic findings were mucosal inflammation (75.9%), lymphoid follicular hyperplasia (56.6%), ulcers (34.8%), and mucosal erosion (25.5%). SBTT was positively correlated with sedation status (r = 0.527, P = 0.000). Examination completion status was weakly correlated with sedation, gastroduodenal reflux, gastric transit time, and SBTT (P 0.05).Conclusion MCCE is safe and feasible for diagnosing pediatric small bowel diseases with high lesion detection rates. Sedation prolongs SBTT but exerts limited impacts on the overall examination completion rate.