Li Fu-Yu, Jiang Li-Sheng, Cheng Jing-Qiu, Mao Hui, Li Ning, Cheng Nan-Sheng
Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu, China.
J Gastroenterol Hepatol. 2007 Dec;22(12):2055-9. doi: 10.1111/j.1440-1746.2007.05018.x. Epub 2007 Jun 25.
Similar to the heartbeat, gastric peristalsis is regulated by an electrical rhythm generated by a pacemaker. Thus, electrical dysrhythmia of gastric slow waves will inevitably affect gastric peristalsis and emptying. The recurrence of postoperative gastroparesis is thereby closely related to the abnormalities of electrical dysrhythmia and ectopic pacemakers, resulting in postoperatively persistent gastric motility disorders in some severe cases, despite the use of prokinetic and antiemetic drugs. Recent studies have demonstrated that gastric pacing, analogous to pacing the human heart, is an attractive and promising therapy that is both feasible and safe. Gastric pacing has been shown to be strikingly effective in normalizing gastric dysrhythmia, increasing the activity of the gastric slow wave and thereby prompting gastric dynamia and emptying. Furthermore, the long-term utilization of gastric pacing can (i) relieve patients from clinical symptoms, such as nausea and vomiting; (ii) release patients with severe postoperative gastroparesis from relying on prokinetic drugs and the jejunal feeding tube; (iii) return patients to normal oral nutritional intake and provide a more satisfactory nutritional status and most importantly; and (iv) give patients a better quality of life. Overall, research focused on gastric pacing has demonstrated excellent prospects for clinical application in the treatment of postoperative gastroparesis disorders, especially for those unresponsive to prokinetic drugs.
与心跳相似，胃蠕动由起搏器产生的电节律调节。因此，胃慢波的电节律紊乱将不可避免地影响胃蠕动和排空。术后胃轻瘫的复发因此与电节律紊乱和异位起搏器的异常密切相关，在一些严重病例中，尽管使用了促动力药和止吐药，但仍导致术后持续的胃动力障碍。最近的研究表明，胃起搏类似于心脏起搏，是一种既可行又安全的有吸引力且有前景的治疗方法。胃起搏已被证明在使胃节律紊乱正常化、增加胃慢波活动从而促进胃动力和排空方面非常有效。此外，长期使用胃起搏可以（i）缓解患者的临床症状，如恶心和呕吐；（ii）使严重的术后胃轻瘫患者不再依赖促动力药物和空肠喂养管；（iii）使患者恢复正常的口服营养摄入并提供更令人满意的营养状况，最重要的是；（iv）给予患者更好的生活质量。总体而言，针对胃起搏的研究已显示出在治疗术后胃轻瘫疾病方面的良好临床应用前景，特别是对于那些对促动力药物无反应的患者。
