Bortolotti M
Department of Internal Medicine and Gastroenterology, University of Bologna Bologna, Italy.
Minerva Gastroenterol Dietol. 2009 Sep;55(3):345-77.
Gastric emptying delay is a rather frequent occurrence that may reveal itself with a broad spectrum of clinical manifestations, from slight dyspeptic symptoms up to alimentary vomiting. Once diagnosed with appropriate examinations, the treatment of this condition may be performed with a variety of means proportionate to the severity of the disease. In the first line there are dietetic measures and pharmacologic aids, that vary from currently available prokinetics drugs, drugs created for other therapeutical purposes, that reveal prokinetic properties, to new classes of prokinetics currently under clinical investigation or clinical trials. In more severe cases of gastroparesis, with vomiting and abdominal pain refractory to prokinetic therapy, other pharmacologic measures can be utilized, such as antiemetic and analgesic drugs. If the medical therapy is insufficient, endoscopic and surgical procedures are available, from the widening of the pyloric ring with botulinum toxin infiltrations or pneumatic dilatation, to the employment of various techniques of gastric electrical stimulation, up to partial or total gastric resection, when any other treatment fails and the patient is kept alive only with partial or total parenteral nutrition.
胃排空延迟是一种较为常见的情况，可能会表现出广泛的临床表现，从轻微的消化不良症状到食源性呕吐。一旦通过适当检查确诊，可根据疾病的严重程度采用多种方法进行治疗。一线治疗方法包括饮食措施和药物辅助，这些方法各不相同，从目前可用的促动力药物、为其他治疗目的而研发但具有促动力特性的药物，到目前正在进行临床研究或临床试验的新型促动力药物。在胃轻瘫更严重的病例中，对于促动力治疗无效的呕吐和腹痛，可采用其他药物措施，如止吐药和镇痛药。如果药物治疗不足，还可采用内镜和外科手术，从用肉毒杆菌毒素注射或气囊扩张来扩大幽门环，到采用各种胃电刺激技术，直至在其他治疗均失败且患者仅靠部分或全胃肠外营养维持生命时进行部分或全胃切除术。
