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特发性胃轻瘫:诊断和治疗方法的病例报告及文献复习。

Idiopathic gastroparesis: case report and literature review of diagnostic and treatment modalities.

机构信息

Department of Internal Medicine, Long Island College Hospital, Brooklyn, NY, USA.

出版信息

Am J Ther. 2013 Jan;20(1):111-7. doi: 10.1097/MJT.0b013e31820543e7.

Abstract

Gastroparesis is a disorder characterized by a delay in gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction. The most common etiologies include diabetes, postsurgical and idiopathic. Idiopathic Gastroparesis is at least as common as diabetic Gastroparesis in most case series. Diagnosis of Gastroparesis is based on the presence of symptoms such as nausea, vomiting, postprandial abdominal fullness, and on an objectively determined delay in gastric emptying. The true prevalence of Gastroparesis is unknown. Gastric emptying can be assessed by scintigraphy and stable isotope breath tests. Management of Gastroparesis consists of dietary and lifestyle measures, possible pharmacological interventions (prokinetics, antiemetics, intrapyloric botulinum toxin injection) and/or interventions that focus on adequate nutrient intake either through a nasoduodenal tube, percutaneous gastrostomy, or jejunostomy. New advances in drug therapy and gastric electrical stimulation techniques have been introduced and might provide new hope to patients. Presented here is an interesting case of idiopathic Gastroparesis along with its management and review of the literature.

摘要

胃轻瘫是一种以胃排空延迟为特征的疾病,在没有机械性胃出口梗阻的情况下出现。最常见的病因包括糖尿病、手术后和特发性。在大多数病例系列中,特发性胃轻瘫至少与糖尿病性胃轻瘫一样常见。胃轻瘫的诊断基于存在恶心、呕吐、餐后腹胀等症状,以及胃排空的客观确定延迟。胃轻瘫的真实患病率尚不清楚。胃排空可以通过闪烁扫描和稳定同位素呼吸试验来评估。胃轻瘫的治疗包括饮食和生活方式措施、可能的药物干预(促动力药、止吐药、幽门内肉毒杆菌毒素注射)和/或通过鼻十二指肠管、经皮胃造口术或空肠造口术专注于充足营养摄入的干预措施。药物治疗和胃电刺激技术的新进展已经推出,可能为患者带来新的希望。本文介绍了一例特发性胃轻瘫的有趣病例及其治疗方法,并对文献进行了回顾。

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