Lin Zhiyue, McElhinney Chris, Sarosiek Irene, Forster Jameson, McCallum Richard
Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Dig Dis Sci. 2005 Jul;50(7):1328-34. doi: 10.1007/s10620-005-2782-7.
To investigate the effect of chronic gastric electrical stimulation (GES) on the daily use of prokinetics and antiemetics, hospitalizations, total symptom score (TSS), SF-36 status for health-related quality of life (HQOL), and gastric emptying of a solid meal, we evaluated 37 gastroparetic patients preoperatively and 1 year after undergoing GES implant. Prokinetic and antiemetic use was significantly reduced. Of 27 patients on at least one prokinetic at baseline, 8 were off at 1 year. Twenty-six patients requiring antiemetics before surgery decreased to 17. Mean TSS was significantly reduced and the reduction for patients off medications was significantly better than for patients still on medications. Overall SF-36 scores for HQOL were significantly improved, and patients off antiemetics had a significantly higher HQOL score than for patients on antiemetics at 1 year. Hospitalizations decreased from 50 +/- 10 days for the year prior to GES therapy to 14 +/- 3 days (P < 0.05). However, gastric emptying was not significantly improved. Conclusions are as follows. (1) Chronic GES significantly reduced the use of prokinetic/antiemetic medications and the need for hospitalization in gastropraretic patients, whose clinical and quality of life outcomes also significantly improved. (2) These data provide evidence of the positive economic impact of this new therapy on long-term clinical outcomes in gastroparetic patients not responding to standard medical therapy.
为研究慢性胃电刺激(GES)对促动力药和止吐药的日常使用、住院情况、总症状评分(TSS)、健康相关生活质量(HQOL)的SF - 36状态以及固体餐胃排空的影响,我们对37例胃轻瘫患者在术前及接受GES植入术后1年进行了评估。促动力药和止吐药的使用显著减少。在基线时至少使用一种促动力药的27例患者中,8例在1年后停用。术前需要使用止吐药的26例患者减少至17例。平均TSS显著降低,停药患者的降低幅度明显优于仍在用药的患者。HQOL的总体SF - 36评分显著改善,在1年时,停用止吐药的患者的HQOL评分显著高于仍在使用止吐药的患者。住院天数从GES治疗前一年的50±10天降至14±3天(P < 0.05)。然而,胃排空未得到显著改善。结论如下:(1)慢性GES显著减少了胃轻瘫患者促动力药/止吐药的使用及住院需求,其临床和生活质量结果也显著改善。(2)这些数据证明了这种新疗法对未对标准药物治疗有反应的胃轻瘫患者的长期临床结果具有积极的经济影响。