Buckles Daniel C, Forster Jameson, McCallum Richard W
Division of Gastroenterology and Hepatology, Department of Medicine, Kansas University Medical Center, Kansas City, USA.
MedGenMed. 2003 Oct 9;5(4):5.
Gastroparesis is a chronic disabling condition of impaired gastric motility that results in decreased quality of life. Currently available medical therapy consists of prokinetic medication combined with antiemetic therapy, dietary modifications, and nutritional supplementation. Many patients continue to have a suboptimal clinical response despite maximal use of these modalities. Instead of surgery, which involves irreversible stomach-modifying procedures, gastric electrical stimulation (GES) with a high-frequency/low-energy stimulus was approved by the US Food and Drug Administration (FDA) and can now be used in this setting. This approach has been shown to decrease symptom frequency and severity, reduce hospitalizations and medical costs, and improve quality of life. Occurrence of complications with this device are uncommon (< 5% of patients). Preliminary studies of new gastric stimulators that restore gastric contractility are promising, but additional investigation is needed. This article reviews the pathophysiology and epidemiology of gastroparesis and the role of conventional medical therapies, and discusses GES therapy with respect to its mechanisms of action, appropriate application, results and benefits, and future directions.
胃轻瘫是一种慢性致残性疾病，胃动力受损，导致生活质量下降。目前可用的药物治疗包括促动力药物联合止吐治疗、饮食调整和营养补充。尽管最大限度地使用了这些治疗方法，许多患者的临床反应仍不理想。胃电刺激（GES）采用高频/低能量刺激，无需进行涉及不可逆胃部改变的手术，已获美国食品药品监督管理局（FDA）批准，现可用于这种情况。这种方法已被证明可减少症状的频率和严重程度，降低住院率和医疗费用，并提高生活质量。该设备并发症的发生率并不常见（<5%的患者）。恢复胃收缩力的新型胃刺激器的初步研究很有前景，但还需要进一步研究。本文综述了胃轻瘫的病理生理学和流行病学以及传统药物治疗的作用，并讨论了GES治疗的作用机制、适当应用、结果和益处以及未来方向。
