Department of Physiology and INSERM UMR-1073/IRIB, Rouen University Hospital, University of Rouen, France.
Dig Liver Dis. 2012 Jul;44(7):563-8. doi: 10.1016/j.dld.2012.01.013. Epub 2012 Mar 3.
Although the efficacy of gastric electrical stimulation has been reported in short-term studies, there is a lack of data on the long-term improvement of nausea and vomiting by gastric electrical stimulation in patients with delayed or normal gastric emptying.
Thirty-one patients were implanted at our centre for medically refractory severe and chronic nausea and/or vomiting. Patients were evaluated at baseline, 6 months then 5 years after implantation (mean follow-up 80±4 months) using a symptomatic and quality of life scores.
Amongst the 31 patients, 4 were lost to follow-up, 6 explanted due to lack of improvement, and 1 patient died. Out of the 20 patients evaluated over 5 years, the quality of life score showed 27% improvement (p<0.01), including nausea (62%; p<0.01), vomiting (111%; p=0.03), satiety (158%; p<0.01), bloating (67%; p<0.01) and epigastric pain (43%; p=0.03). Over 5 years, 15/20 patients reported a 50% improvement with a global satisfaction rated at 64±6%. Therefore, 15/27 patients (56%) were improved by gastric electrical stimulation over 5 years in intention to treat. Improvement of nausea 6 months after implantation was predictive of 5-year success of gastric electrical stimulation (p=0.04). Finally, patients with delayed gastric emptying or with normal gastric emptying rate before surgery were similarly improved over 5 years (60% versus 50% respectively).
Gastric electrical stimulation is safe and effective in the long term in patients with medically refractory nausea and vomiting, with an efficacy over 50% beyond 5 years in intention to treat. Gastric emptying measured before implantation did not influence the response rate over 5 years.
尽管胃电刺激的疗效已在短期研究中得到报道，但对于胃电刺激在胃排空延迟或正常的患者中改善恶心和呕吐的长期效果，数据仍然缺乏。
我们中心为 31 名患有医学难治性严重和慢性恶心和/或呕吐的患者植入了设备。患者在基线时、植入后 6 个月和 5 年时（平均随访 80±4 个月）进行评估，使用症状和生活质量评分。
在 31 名患者中，有 4 名失访，6 名因无改善而取出，1 名患者死亡。在 5 年内评估的 20 名患者中，生活质量评分显示改善了 27%（p<0.01），包括恶心（62%；p<0.01）、呕吐（111%；p=0.03）、饱腹感（158%；p<0.01）、腹胀（67%；p<0.01）和上腹痛（43%；p=0.03）。5 年内，15/20 名患者报告改善了 50%，总体满意度评分为 64±6%。因此，27 名患者中有 15 名（56%）在 5 年内通过胃电刺激得到了改善（意向治疗）。植入后 6 个月时恶心的改善可预测胃电刺激 5 年的成功率（p=0.04）。最后，胃排空延迟或手术前胃排空率正常的患者在 5 年内同样得到了改善（分别为 60%和 50%）。
胃电刺激在长期治疗医学难治性恶心和呕吐患者中是安全有效的，在 5 年意向治疗中，超过 50%的患者有疗效。植入前测量的胃排空率并不影响 5 年的反应率。
