Small-bowel capsule endoscopy in patients with unexplained chronic abdominal pain: a systematic review
Small-bowel capsule endoscopy in patients with unexplained chronic abdominal pain: a systematic review
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小肠胶囊内镜检查在不明原因慢性腹痛患者中的应用：系统评价
DOI：
10.1016/j.gie.2014.04.062
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发表时间：
2015-01-01
影响因子：
7.7
通讯作者：
Chen, Shujie
中科院分区：
文献类型：
--
作者：
Xue, Meng;Chen, Xueqin;Chen, Shujie
背景：患者在经历慢性腹痛时经常咨询初级保健医生和胃肠病学家。虽然它在这些情况下的诊断效果是不确定的，小肠胶囊式内窥镜（SBCE）已被用于评估不明原因的腹痛。目的：评估SBCE在不明原因慢性腹痛患者中的诊断率。设计：我们回顾性分析了报告SBCE在不明原因慢性腹痛患者中的诊断率的文献，并计算了SBCE的总体诊断率。yield.Setting:两名研究者独立地从数据库中检索研究并分析结果。患者：共纳入21项研究的1520例患者。干预措施：小肠胶囊式内窥镜检查。主要结果测量：通过随机效应模型评估每例患者的诊断率及其95%置信区间（CI）。结果：SBCE对不明原因慢性腹痛患者的合并诊断率为20.9%（95% CI，15.9%~ 25.9%），异质性高（I-2 = 80.0%，P <0.001）。炎症性病变是最常见的阳性结果（78.3%），其次是肿瘤（9.0%）。局限性：异质性的研究，回顾性设计，腹痛的可变慢性，和不同的先前检查SBCE.Conclusion：SBCE提供了一个非侵入性的诊断工具，不明原因的慢性腹痛患者，但诊断率有限（20.9%）。在阳性结果的患者中，炎性病变最常见。
Background: Patients frequently consult primary care physicians and gastroenterologists when experiencing chronic abdominal pain. Although its diagnostic efficacy in these settings is uncertain, small-bowel capsule endoscopy (SBCE) has been used to evaluate the unexplained reasons for abdominal pain.Objective: To evaluate the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain.Design: We performed a retrospective review of publications reporting the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain and calculated the overall diagnostic yield.Setting: Two investigators independently searched studies from databases and analyzed the results.Patients: A total of 1520 patients from 21 studies were included.Interventions: Small-bowel capsule endoscopy.Main Outcome Measurements: Per-patient diagnostic yield, with 95% confidence intervals (CI), was evaluated by a random-effect model. Clear categorical analysis also was performed.Results: The pooled diagnostic yield of SBCE in patients with unexplained chronic abdominal pain was 20.9% (95% CI, 15.9%-25.9%), with high heterogeneity (I-2 = 80.0%; P < .001). Inflammatory lesions were the most common (78.3%) positive findings, followed by tumors (9.0%).Limitations: Heterogeneity among studies, retrospective design, variable chronicity of abdominal pain, and different previous examinations before SBCE.Conclusion: SBCE provides a noninvasive diagnostic tool for patients with unexplained chronic abdominal pain, but the diagnostic yield is limited (20.9%). Among patients with positive findings, inflammatory lesions are the most common.