Koch Kenneth L
Section of Gastroenterology and Hepatology, Wake Forest University Health Sciences Center, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Curr Gastroenterol Rep. 2003 Aug;5(4):323-30. doi: 10.1007/s11894-003-0070-2.
Gastric neuromuscular disorders encompass a spectrum of dysfunction in nerve and smooth muscle that includes gastric visceral hypersensitivity, gastric dysrhythmias, fundic dysfunction, antral hypomotility, and gastroparesis. Patients with each disorder may present with such vague dyspepsia symptoms as early satiety, upper abdominal discomfort, bloating, or nausea with or without vomiting. A careful history and physical examination may suggest a gastric neuromuscular disorder, but symptoms are nonspecific. Gastroparesis is the most severe form of neuromuscular dysfunction. Such reversible causes of gastroparesis as mechanical obstruction of the stomach and chronic mesenteric ischemia must be excluded. Gastroparesis, gastric dysrhythmias, and hypersensitivity may follow viral infection or be due to degenerative processes that affect the gastric enteric neurons, smooth muscle, or interstitial cells of Cajal. Commonly, the cause of these gastric neuromuscular disorders is unknown. An approach to the diagnosis and treatment of gastric neuromuscular disorders is reviewed, including dietary counseling, drugs, and medical devices.
胃神经肌肉疾病包括神经和平滑肌的一系列功能障碍，其中包括胃内脏高敏感性、胃节律紊乱、胃底功能障碍、胃窦动力不足和胃轻瘫。每种疾病的患者可能会出现诸如早饱、上腹部不适、腹胀或伴有或不伴有呕吐的恶心等模糊的消化不良症状。详细的病史和体格检查可能提示胃神经肌肉疾病，但症状并无特异性。胃轻瘫是神经肌肉功能障碍最严重的形式。必须排除胃轻瘫的可逆性病因，如胃机械性梗阻和慢性肠系膜缺血。胃轻瘫、胃节律紊乱和高敏感性可能继发于病毒感染，或由影响胃肠神经元、平滑肌或 Cajal 间质细胞的退行性病变引起。通常，这些胃神经肌肉疾病的病因不明。本文综述了胃神经肌肉疾病的诊断和治疗方法，包括饮食咨询、药物和医疗器械。
