Islam Saleem
Division of Pediatric Surgery, University of Florida, Gainesville, Florida, USA.
Curr Opin Pediatr. 2015 Jun;27(3):377-82. doi: 10.1097/MOP.0000000000000216.
Gastroparesis is a disorder with delayed gastric emptying in the absence of mechanical obstruction. It is one of the more common dysmotilities that occur in the gastrointestinal tract, and is thought to primarily affect adults. Pediatric cases of gastroparesis were considered rare; however, recent evidence suggests growing recognition in children and adolescents. Therefore, it is important for the pediatric caregiver to understand the condition and the treatment options available.
The majority of patients are women, and presentation is usually with symptoms of persistent nausea, emesis, postprandial pain and bloating, and early satiety. Weight loss may occur in some cases, though this is not universal. The majority of cases are idiopathic, with diabetes mellitus the second most common cause.
Treatment consists of symptomatic relief with medication to counteract the nausea, emesis, pain, bloating, gastroesophageal reflux, early satiety, and improve gastric emptying. Dietary modification is also used with small meals and avoidance of high fiber and fat-containing foods. Recalcitrant cases of gastroparesis require the use of additional approaches such as jejunal feeds, intrapyloric botulinum toxin, gastric emptying procedures such as pyloroplasty, and gastric electrical stimulation. We will review these options in this article.
胃轻瘫是一种在无机械性梗阻情况下胃排空延迟的疾病。它是胃肠道中较常见的运动障碍之一，主要影响成年人。过去认为小儿胃轻瘫病例罕见；然而，最近的证据表明其在儿童和青少年中的发病率正逐渐受到更多关注。因此，儿科护理人员了解这种疾病及其可用的治疗方案很重要。
大多数患者为女性，症状通常表现为持续性恶心、呕吐、餐后疼痛和腹胀，以及早饱。部分病例可能出现体重减轻，但并非普遍现象。大多数病例为特发性，糖尿病是第二常见病因。
治疗包括使用药物缓解症状，以对抗恶心、呕吐、疼痛、腹胀、胃食管反流、早饱，并改善胃排空。饮食调整也很重要，建议少食多餐，避免高纤维和高脂肪食物。难治性胃轻瘫病例需要采用其他方法，如空肠喂养、幽门内注射肉毒杆菌毒素、胃排空手术（如幽门成形术）以及胃电刺激。我们将在本文中对这些选择进行综述。
