Kauer W K, Stein H J, Balint A, Siewert J R
Department of Surgery, Klinikum rechts der Isar der TU Munchen, Germany.
Hepatogastroenterology. 1999 Mar-Apr;46(26):1244-8.
BACKGROUND/AIMS: With the development of high-performance computer programs, transcutaneous electrogastrography has experienced a renaissance in the last few years and is widely recommended as a non-invasive diagnostic tool to evaluate functional gastric disorders. We assessed the clinical value of electrogastrography in symptomatic and asymptomatic patients after a variety of procedures of the upper gastrointestinal (GI) tract.
Electrogastrography tracings were recorded with a commercially available data logger using a recording frequency of 4 Hz. A standard meal was given between a 60 min preprandial and a 60 min postprandial period. The following parameters were analyzed pre- and postprandially utilizing Fourier and spectral analysis: Regular gastric activity (2-4 cycles/minute), bradygastria (0.5-2 cycles/minute), tachygastria (4-9 cycles/minute), dominant frequency and power of the dominant frequency. Nineteen asymptomatic healthy volunteers served as a control group. Forty-nine patients, who had undergone upper intestinal surgery, were included in the study (cholecystectomy n = 10, Nissen fundoplication n = 10, subtotal gastrectomy n = 8, truncal vagotomy, and gastric pull-up as esophageal replacement n = 6). Twenty of these patients complained of epigastric symptoms post-operatively, while 12 of these 20 patients also had a scintigraphic gastric emptying study with Tc99m labeled semisolid meal.
Preprandial gastric electric activity was between 2 and 4 cycles/minute in 60-90% of the study time in healthy volunteers. In all study groups the prevalence and power of normal electric activity increased significantly after the test meal (p < 0.001). After cholecystectomy, Nissen fundoplication, subtotal gastrectomy or vagotomy and gastric pull-up pre- and postprandial gastric electric activity showed a greater variability compared to normal volunteers (p < 0.05), but no typical electrogastrography pattern could be identified for the different surgical procedures. There was no significant difference in the electrogastrography pattern between asymptomatic and symptomatic patients and patients with normal or abnormal scintigraphic gastric emptying curves.
There is no specific electrogastrography pattern to differentiate between typical surgical procedures or epigastric symptoms. To date, electrogastrography does not contribute to the diagnosis and analysis of gastric motility disorders after upper intestinal surgery.
背景/目的：随着高性能计算机程序的发展，在过去几年中，经皮胃电图检查迎来了复兴，并被广泛推荐作为评估功能性胃部疾病的一种非侵入性诊断工具。我们评估了上消化道（GI）各种手术后有症状和无症状患者的胃电图临床价值。
使用市售数据记录仪，以4Hz的记录频率记录胃电图描记图。在餐前60分钟至餐后60分钟期间给予标准餐。利用傅里叶和频谱分析在餐前和餐后分析以下参数：正常胃活动（2 - 4个周期/分钟）、胃动过缓（0.5 - 2个周期/分钟）、胃动过速（4 - 9个周期/分钟）、主频及主频功率。19名无症状健康志愿者作为对照组。49例接受上消化道手术的患者纳入研究（胆囊切除术n = 10，nissen胃底折叠术n = 10，胃大部切除术n = 8，迷走神经切断术及胃上提术作为食管替代术n = 6）。其中20例患者术后出现上腹部症状，这20例患者中的12例还进行了用Tc99m标记的半固体餐的闪烁扫描胃排空研究。
在健康志愿者中，餐前胃电活动在60 - 90%的研究时间内为2 - 4个周期/分钟。在所有研究组中，试餐后正常电活动的发生率和功率显著增加（p < 0.001）。与正常志愿者相比，胆囊切除术、nissen胃底折叠术、胃大部切除术或迷走神经切断术及胃上提术后的餐前和餐后胃电活动显示出更大的变异性（p < 0.05），但不同手术操作未发现典型的胃电图模式。无症状和有症状患者以及闪烁扫描胃排空曲线正常或异常的患者之间，胃电图模式无显著差异。
没有特定的胃电图模式来区分典型的手术操作或上腹部症状。迄今为止，胃电图对上消化道手术后胃动力障碍的诊断和分析没有帮助。
