Mason Rodney J, Lipham John, Eckerling Gordon, Schwartz Alan, Demeester Tom R
Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA.
Arch Surg. 2005 Sep;140(9):841-6; discussion 847-8. doi: 10.1001/archsurg.140.9.841.
Gastric electrical stimulation is an alternative to gastrectomy in patients with refractory gastroparesis.
Retrospective case series with a median follow-up of 20 months.
A tertiary care university hospital and a university-affiliated community hospital.
Twenty-nine patients (22 women, 7 men; median age, 39 years; age range, 20-87 years) with debilitating gastroparesis who were referred for gastrectomy from December 10, 2001, through October 1, 2004. Twenty-four patients had type 1 diabetic gastroparesis and 5 patients had idiopathic gastroparesis.
Placement of a gastric stimulator device laparoscopically in 24 patients and by laparotomy in 5 patients.
Morbidity and mortality of the procedure, symptom control, hospital readmissions, need for supplemental nutritional support, body mass index (calculated as weight in kilograms divided by the square of height in meters), and gastric emptying.
Follow-up results were available in 27 patients. There was no 30-day mortality or morbidity in 4 patients. The median hospital stay was 3 days. All of the patients tolerated an oral diet at discharge. Symptom control was excellent to good in 19 patients. Nutritional support was discontinued in the 19 patients who were dependent on supplemental feeding before the procedure (P<.001). The median body mass index improved significantly (22.9 preoperatively vs 25.1 postoperatively; P = .006). The median gastric emptying rate (percentage per minute) was measured in 15 of the 27 patients postoperatively and showed significant improvement (0.17% per minute preoperatively vs 0.38% per minute postoperatively; P<.001). Additional procedures were required in 4 patients (owing to poor outcome in 3 patients).
Gastric electrical stimulation ameliorated symptoms, returned patients to normal oral nutritional intake, increased body mass index, improved gastric emptying rates, and is an alternative to gastrectomy in patients with end-stage gastric disease.
对于难治性胃轻瘫患者，胃电刺激是胃切除术的一种替代方法。
回顾性病例系列研究，中位随访时间为20个月。
一家三级医疗大学医院和一家大学附属社区医院。
29例（22例女性，7例男性；中位年龄39岁；年龄范围20 - 87岁）患有使人衰弱的胃轻瘫的患者，于2001年12月10日至2004年10月1日被转诊接受胃切除术。24例患者患有1型糖尿病性胃轻瘫，5例患者患有特发性胃轻瘫。
24例患者通过腹腔镜放置胃刺激器装置，5例患者通过剖腹手术放置。
手术的发病率和死亡率、症状控制、再次入院情况、补充营养支持的需求、体重指数（计算方法为体重千克数除以身高米数的平方）以及胃排空情况。
27例患者有随访结果。4例患者无30天死亡率或发病率。中位住院时间为3天。所有患者出院时均能耐受经口饮食。19例患者症状控制良好至优秀。术前依赖补充喂养的19例患者停止了营养支持（P <.001）。中位体重指数显著改善（术前为22.9，术后为25.1；P = .006）。27例患者中有15例术后测量了中位胃排空率（每分钟百分比），显示有显著改善（术前每分钟0.17%，术后每分钟0.38%；P <.001）。4例患者需要进行额外手术（3例患者因效果不佳）。
胃电刺激改善了症状，使患者恢复正常经口营养摄入，增加了体重指数，提高了胃排空率，是终末期胃病患者胃切除术的一种替代方法。
