Jian R
Service d'Hépato-Gastroentérologie, Hôpital Saint-Louis, Paris.
Presse Med. 1992 Jun 20;21(23):1072-8.
Disorders of gastric emptying are observed in many clinical situations. Their symptoms are diverse and correlate poorly with the objective abnormalities of gastric emptying. The underlying mechanism consists of abnormalities of basal electrical rhythm, fundic compliance, post-prandial antral motricity and, above all, antro-pyloro-duodenal co-ordination, associated to varying degrees. Among possible causes 3 clinical situations predominate: diabetes mellitus, functional gastrointestinal disorders (idiopathic dyspepsia) and sequelae of gastric surgery where retention of solids and accelerated evacuation of liquids may coexist in the same patient. Treatment of gastric incontinence rests, almost exclusively, on dietary measures, but several drugs, such as metoclopramide, domperidone and cisapride, are available to treat gastric stasis. Other compounds, notably motilin agonists (erythromycin and its derivatives) are currently being evaluated and will reinforce this therapeutic armentarium in a not too distant future.
胃排空障碍在许多临床情况下均可观察到。其症状多样，且与胃排空的客观异常相关性较差。潜在机制包括基础电节律异常、胃底顺应性异常、餐后胃窦动力异常，尤其是胃窦 - 幽门 - 十二指肠协调性异常，这些异常程度各异。在可能的病因中，有三种临床情况较为常见：糖尿病、功能性胃肠病（特发性消化不良）以及胃手术后的后遗症，同一患者可能同时存在固体潴留和液体排空加速的情况。胃失禁的治疗几乎完全依赖饮食措施，但也有几种药物，如甲氧氯普胺、多潘立酮和西沙必利，可用于治疗胃潴留。其他化合物，特别是胃动素激动剂（红霉素及其衍生物）目前正在评估中，在不久的将来将增强这一治疗手段。
