Xing J H, Chen J D Z
Veterans Research Foundation, Oklahoma City, Oklahoma, USA.
Dig Dis Sci. 2006 Dec;51(12):2160-4. doi: 10.1007/s10620-006-9212-3. Epub 2006 Nov 1.
Gastric electrical stimulation (GES) improves symptoms in patients with gastroparesis. We sought to determine if stimulation at fundus with parameters used for gastroparesis could affect gastric accommodation and distention-induced symptoms in dogs. Nine dogs were implanted with a gastric cannula at the anterior stomach and 1 pair of stimulation electrodes in the fundus. Assessment of gastric accommodation and a series of gastric distention were performed using a barostat. Stimulation parameters were of short pulse trains of 14 Hz, 5 mA, 0.3 ms, and 0.1 s on, 5 s off. GES at fundus significantly decreased fasting gastric tone. Fasting gastric volume was significantly increased from 56.3+/-10.4 mL at baseline to 102.4+/-23.1 mL with stimulation (P=.011). Postprandial gastric accommodation was significantly enhanced with stimulation. The extent of accommodation increased from 249.3+/-39.9 mL in the control session to 325.8+/-25.1 mL with stimulation (P=.011). Symptom scores induced by balloon distention of the stomach were significantly lower during stimulation in comparison with those of baseline (P=.016). In conclusion, GES with parameters for gastroparesis enhances postprandial gastric accommodation and reduces visceral perception in normal dogs. This effect, if seen also in humans, may explain in part the symptomatic improvement associated with GES therapy in patients with gastroparesis.
胃电刺激(GES)可改善胃轻瘫患者的症状。我们试图确定,采用胃轻瘫治疗参数对犬胃底进行刺激是否会影响胃容纳功能以及由扩张引起的症状。9只犬在前胃植入胃套管,并在胃底植入1对刺激电极。使用恒压器评估胃容纳功能并进行一系列胃扩张操作。刺激参数为14Hz、5mA、0.3ms的短脉冲串,开启0.1s,关闭5s。胃底的GES显著降低空腹胃张力。空腹胃容量从基线时的56.3±10.4mL显著增加至刺激时的102.4±23.1mL(P = 0.011)。刺激后餐后胃容纳功能显著增强。容纳程度从对照期的249.3±39.9mL增加至刺激时的325.8±25.1mL(P = 0.011)。与基线相比,刺激期间胃气囊扩张引起的症状评分显著降低(P = 0.016)。总之,采用胃轻瘫治疗参数的GES可增强正常犬的餐后胃容纳功能并降低内脏感觉。如果在人类中也观察到这种效应,可能部分解释了胃轻瘫患者接受GES治疗后症状改善的原因。
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