超全讲解：胃镜、肠镜、胶囊内镜！

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                    <p><img class="rich_pages" data-cropselx1="0" data-cropselx2="578" data-cropsely1="0" data-cropsely2="116" data-ratio="0.2053388090349076" data-s="300,640" src="http://mmbiz.qpic.cn/mmbiz_jpg/Y0IKJZGxxOaMb5Usich3FpwdFv7cAkrau3NKsEmTd3pBAlAyIulVy4fwTrj9RUpibk6YwDMSQhONic8iaVmKjmzqZg/640?wx_fmt=jpeg" data-type="jpeg" data-w="974" style="width: 578px;height: 119px;"  /></p><section data-role="outer" label="Powered by gulangu" style="white-space: normal;"><section data-role="outer" label="Powered by gulangu"><h1></h1><p><strong><span style="font-size: 14px;">来源：</span></strong><span style="color: rgb(255, 76, 65);"><strong><span style="font-size: 14px;">胃肠病</span></strong></span><strong><span style="font-size: 14px;">&nbsp; &nbsp; &nbsp;</span></strong><span style="color: rgb(42, 39, 39);"><strong><span style="font-size: 14px;">微信公众号ID：Wei-ni-hao-</span></strong></span></p><section powered-by="gulangu"><section><section><section data-role="outer" label="Powered by gulangu"><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><h1 style="max-width: 100%;color: rgb(51, 51, 51);"><span style="max-width: 100%;color: rgb(136, 136, 136);box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="max-width: 100%;font-size: 14px;box-sizing: border-box !important;word-wrap: break-word !important;"></span></strong></span><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-role="paragraph" data-color="rgb(216, 40, 33)" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><article data-author="gulangu" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-tools="gulangu" data-id="90140" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="paragraph" data-color="rgb(216, 40, 33)" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;color: rgb(62, 62, 62);line-height: 23.2727px;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="outer" label="Powered by gulangu" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-tools="gulangu" data-id="87758" style="max-width: 100%;box-sizing: border-box;line-height: 25.6px;border-width: 0px;border-style: none;border-color: initial;word-wrap: break-word !important;"><section style="margin-top: 2px;margin-bottom: 2px;max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section style="padding: 10px;max-width: 100%;box-sizing: border-box;border-width: 1px;border-style: dashed;border-color: rgb(33, 33, 34);font-size: 14px;line-height: 1.75em;word-wrap: break-word !important;"><p><span style="font-size: 16px;max-width: 100%;color: rgb(255, 0, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">导语：</strong></span><span style="color: rgb(0, 0, 0);font-size: 16px;">在消化系统疾病的检查方法中，内镜是最重要的手段之一，胃镜、肠镜、无痛内镜等。</span></p></section></section></section></section></section></section></section></section></section></article></section></section></section></h1></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section><section powered-by="gulangu"><section><section><section data-role="outer" label="Powered by gulangu" style="font-size: 16px;"><section data-role="outer" label="Powered by gulangu"><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong>那么，这些检查都适合哪些患者？哪些患者又不适合去做？检查之前和之后有什么注意事项吗?</strong></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">今天和大家一起讨论一下这个话题！<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;"><img data-copyright="0" data-ratio="0.6513888888888889" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ0r4jVb9JI9gTocLrgpW9bibxDxJUuibP7W4BPEO4ialJQpmhHvHAWicZaDw/640?wx_fmt=jpeg" data-w="720"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">（↑胃镜检查）</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">一、胃镜</strong></span></p><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">胃镜可以观察食管、胃、十二指肠球部和降部的黏膜，以确定病变的部位及性质，并取活体组织做检查，协助诊断上消化道炎症、溃疡、肿瘤、息肉、憩室、狭窄、畸形或异物等疾病。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">适应症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">1、存在上消化道症状(如烧心、吞咽困难、上腹痛、呕吐等)，怀疑有食管、胃、十二指肠病变，临床需要确诊者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">2、已确诊的上消化道病变，如消化性溃疡、食管癌、胃癌等疾病治疗后需要随访或观察疗效者。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">3、消化道出血，病因及部位不明者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">4、影像学检查发现上消化道病变，需要明确性质者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">5、上消化道异物者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">6、需要进行内镜下治疗者，如食管胃底静脉曲张行套扎或注射硬化剂治疗，胃早癌行内镜下黏膜剥离术(ESD)等。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">7、胃癌家族史及其他胃癌高危人群。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">8、存在幽门螺杆菌感染，需要明确是否有胃黏膜病变者，或者需要进行幽门螺杆菌培养及药物敏感性试验以指导治疗者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">禁忌症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;">绝对禁忌：</span></strong>严重心肺功能不全、处于休克等危重状态者、不能合作者、内镜插入途径有严重急性炎症和内脏穿孔者。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">相对禁忌：</strong></span>心肺功能不全，出血倾向伴血红蛋白低于50g/L，高度脊柱畸形，食管或十二指肠巨大憩室等。<br style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;text-align: center;"><img data-copyright="0" data-ratio="0.8695652173913043" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ08lmwTNZ44cut7FKgWl4WUzPzKBPMrRUUJHRsQbhLdgicZ3PoDAeD1mA/640?wx_fmt=jpeg" data-w="345"  /></p><p style="white-space: normal;text-align: center;">（↑胃镜检查示意图）</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">检查前准备及查后注意：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">1、长期口服阿司匹林、氯吡格雷、华法林等抗凝药物的患者，需与相关科室医生充分沟通，在医生检查前需停药1周，防止发生消化道大出血。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">2、检查前一天晚上10：00起开始禁食、禁水至次日检查时。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">3、高血压患者检查当日早晨可用一小口水送服降压药物，防止检查过程中因血压过高发生不良反应。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">4、糖尿病患者检查当日早晨应暂停降糖药或胰岛素。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">5、吸烟的患者，检查前1天起还需戒烟，以免检查时因咳嗽影响操作，同时，禁烟还可以减少胃酸分泌，便于观察。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">6、检查前需完善血常规、肝功能、凝血功能、感筛检查。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">7、年纪较大的患者还需要完善胸片、心电图、超声心动图等检查，以评估患者能否耐受内镜检查。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">8、检查后由于咽部麻醉作用未消失，仍需禁食、禁水2小时，2小时后可先试饮水，若无吞咽困难及呛咳，再逐渐过渡到温软食物。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">9、检查后：1-2日应避免刺激性饮食。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">10、若出现严重的腹痛或黑便等情况，需及时去医院就诊。</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">胃镜检查的并发症和风险主要包括出血、穿孔、感染、心律失常、心肌缺血、咽喉损伤、下颌关节脱臼等，但常规检查发生几率都非常低，而且可以通过充分的术前准备和谨慎操作尽量避免。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">二、结肠镜</strong></span></p><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><p style="white-space: normal;text-align: center;"><img data-copyright="0" data-ratio="0.7355555555555555" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ0CTUpUSJzIGzQrSJ0QiaTBDof81uP3libfyKq3LX5JMa4o7wth5bfxmqQ/640?wx_fmt=jpeg" data-w="450"  /></p><p style="white-space: normal;text-align: center;">（↑肠镜检查示意图）</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">结肠镜可以观察包括直肠、乙状结肠、降结肠、横结肠、升结肠、盲肠至回肠末端的肠道黏膜，主要用于诊断结、直肠炎症，良恶性肿瘤，息肉，憩室等疾病。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">适应症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">原因不明的下消化道出血，包括便血和持续性便潜血阳性。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">存在下消化道症状，如腹痛、腹泻、便秘、腹部包块、大便习惯改变等可疑结直肠疾病。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">钡剂灌肠或影像学检查发现可疑病变不能定性。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">炎症性肠病做鉴别诊断或需要确定病变范围、严重程度等以及治疗后的复查。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">结直肠肿瘤术后或结直肠息肉切除术后的定期随访。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">禁忌症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">除胃镜检查的禁忌症外，还包括肠梗阻、中毒性巨结肠、对肠道清洁剂成分过敏等情况。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">检查前准备：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">同胃镜检查相似，但是高血压患者检查当日早晨降压药物照常服用。糖尿病患者检查日晨暂停降糖药或胰岛素。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">检查前1天应低渣饮食(如稀饭、面条、面包、鸡蛋羹等)，以提高肠道准备的清洁度，前1天晚餐后禁食(可以饮水)。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">肠镜前需完善的检查同胃镜。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">肠道准备：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">由于过多的肠道残留物会在检查时影响医生的判断，因此肠道准备的目的在于清除肠道内容物，充分暴露肠道黏膜以便观察。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">肠道清洁剂的种类方面，目前国内多用聚乙二醇电解质散、50%硫酸镁等清洁肠道。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">服药后需来回走动，否则会影响清肠效果。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;"><img data-copyright="0" data-ratio="1.3716814159292035" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ0nFa8ZsXXx1D7TLERFYwL2vCHjjFehrh4dXJpLhG1MibVrlSdW2uDgNQ/640?wx_fmt=jpeg" data-w="565"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;">（↑肠道准备示意图）</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">如有严重腹胀或不适，可放慢服用速度或暂停服用，待症状消除后再继续服用，可以观察大便性状判断肠道准备效果，若排出大便为清水样，说明肠道准备充分。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">对于不能获得充分肠道清洁的患者，可以行清洁灌肠或再次进行加强的肠道准备。</p><p style="white-space: normal;text-align: center;"><img data-copyright="0" data-ratio="1.0844748858447488" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ0Hw6pOT6jD1180XZwTKAYia2HBVhPTy9pM1v1JtpqLibVkibR4uxNmVlhA/640?wx_fmt=jpeg" data-w="438"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(136, 136, 136);box-sizing: border-box !important;word-wrap: break-word !important;">（↑结肠镜检查示意图）</span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">检查后：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">出现轻度腹痛、腹胀为正常现象，与检查时注入空气等操作有关，无需紧张。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">若出现严重的腹痛、腹胀或便血，需及时就诊。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">腹痛、腹胀等症状消失后即可进食、水，尽量食用软食，如稀饭、鱼类等，避免高纤维及辛辣食物。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">结肠镜检查的并发症和风险主要包括穿孔、出血、感染、心律失常、心肌缺血、操作不成功及肠道准备过程中出现的水电解质紊乱等，但也都可以通过充分的术前准备和谨慎规范的操作尽量避免。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">三、胶囊内镜</strong></span></p><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><hr style="white-space: normal;max-width: 100%;border-color: rgb(255, 10, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><img data-copyright="0" data-ratio="0.6866666666666666" data-s="300,640" data-type="jpeg" src="http://mmbiz.qpic.cn/mmbiz_jpg/KzHiaQNmS8ibocKp7061zVF7hibxDsenzZ0Bnxdj1PZRCWAHVpFkv0fWiabL6Rp7SZ3LAafpAicjwJg1ibcIcdSibjDtQ/640?wx_fmt=jpeg" style="box-sizing: border-box !important;word-wrap: break-word !important;width: auto !important;visibility: visible !important;" data-w="600"  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;">（↑磁控胶囊内镜）</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">胶囊内镜检查是指患者口服智能胶囊，借助消化道蠕动使之在消化道内运动、拍摄图像，从而了解受检者的消化道情况，对其病情做出诊断。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">适应症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">包括不明原因消化道出血、不明原因缺铁性贫血、疑似小肠肿瘤、疑似或难以控制的吸收不良综合征、检测非甾体类消炎药相关性小肠黏膜损伤，及临床上需要排除小肠疾病者，还可用于监测并指导克罗恩病的治疗及小肠息肉病综合征的发展。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">禁忌症：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">绝对禁忌证：</strong></span>无手术条件或拒绝接受任何腹部手术者(一旦胶囊滞留将通过手术取出)。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(255, 10, 0);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">相对禁忌证：</strong></span>已知或怀疑胃肠道梗阻、狭窄及痿管；心脏起搏器或其他电子仪器植入者；吞咽障碍者；孕妇。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">术前准备：</strong></span></p><hr style="white-space: normal;border-color: rgb(255, 10, 0);"  /><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">检查前需禁食10-12小时，检查前晚行肠道清洁准备(同结肠镜准备)，以提高图像的清晰度；</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">术前半小时可服用适量祛泡剂，以减少泡沫对视野的影响。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">在服用胶囊2小时后可饮清水，4小时后可以进少许清淡食物。在胶囊电池耗尽时或胶囊经回盲瓣进入结肠后结束检查。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">胶囊内镜检查的并发症包括胶囊滞留、误吸入气道等。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">胶囊内镜检查后胶囊停留于胃肠道2周以上则定义为胶囊滞留，应及时就诊，通过外科手术或气囊辅助式小肠镜予以取出。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="color: rgb(255, 10, 0);"><span style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">至于患者是否该做内镜检查?</strong></span><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">是否能做内镜检查?</strong><strong style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;">做何种检查?</strong></span></p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;">具体需要根据患者的具体情况，由专科医生判断，做好充分准备，才能保障患者的安全和检查的质量。</p><p style="white-space: normal;max-width: 100%;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br  /></p></section></section><p style="text-align: center;"><strong style="color: rgb(136, 136, 136);"><span style="max-width: 100%;font-size: 14px;box-sizing: border-box !important;word-wrap: break-word !important;">—&nbsp;THE 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