World J Gastroenterol. 2011 Jan 21;17(3):273-82. doi: 10.3748/wjg.v17.i3.273.
The lack of an effective medical treatment for gastroparesis has pushed the research of new techniques of gastric electrical stimulation (GES) for nearly half a century of experimentation with a large variety of electrical stimuli delivered to the gastric wall of animals and patients with gastroparesis. Three principal methods are currently available: gastric low-frequency/high-energy GES with long pulse stimulation, high-frequency/low-energy GES with short pulse stimulation and neural sequential GES. The first method aims to reset a regular slow wave rhythm, but has variable effects on contractions and requires devices with large and heavy batteries unsuitable for implantation. High-frequency/low-energy GES, although inadequate to restore a normal gastric electro-mechanical activity, improves dyspeptic symptoms, such as nausea and vomiting, giving patients a better quality of life together with a more satisfactory nutritional status and is suitable for implantation. Unfortunately, the numerous clinical studies using this type of GES, with the exception of two, were not controlled and there is a need for definitive verification of the effectiveness of this technique to justify the cost and the risks of this procedure. The last method, which is neural sequential GES, consists of a microprocessor-controlled sequential activation of a series of annular electrodes along the distal two thirds of the stomach and is able to induce propagated contractions causing forceful emptying of the gastric content. The latter method is the most promising, but has been used only in animals and needs to be tested in patients with gastroparesis before it is regarded as a solution for this disease.
胃轻瘫缺乏有效的治疗方法，这促使人们将近半个世纪以来一直在探索新的胃电刺激（GES）技术，对动物和胃轻瘫患者的胃壁进行了各种不同的电刺激实验。目前有三种主要方法：胃低频/高能 GES 采用长脉冲刺激、高频/低能 GES 采用短脉冲刺激和神经序贯 GES。第一种方法旨在重置规则的慢波节律，但对收缩的影响具有可变性，并且需要使用带有大型重电池的设备，这些设备不适合植入。高频/低能 GES 虽然不足以恢复正常的胃电机械活动，但可以改善消化不良症状，如恶心和呕吐，使患者的生活质量更好，营养状况更满意，并且适合植入。不幸的是，除了两项之外，使用这种类型的 GES 的大量临床研究都没有得到控制，因此需要对该技术的有效性进行明确验证，以证明该程序的成本和风险是合理的。最后一种方法是神经序贯 GES，它由微处理器控制沿着胃的远端三分之二依次激活一系列环形电极，能够引发传播性收缩，从而有力地排空胃内容物。后一种方法最有前途，但仅在动物中使用，需要在胃轻瘫患者中进行测试，然后才能将其视为该疾病的解决方案。
