Can J Gastroenterol Hepatol. 2015 May;29(4):198-202. doi: 10.1155/2015/406039.
The efficacy of gastric neurostimulation therapy for diabetic gastroparesis (GP) in a 'real-life' Canadian setting has not been assessed.
To assess changes in health-related quality of life (QoL), weekly vomiting frequency (WVF), total symptom score (TSS) and health care utilization 12 months before and after gastric neurostimulator implantation in a diabetic GP cohort.
Medication-refractory diabetic GP patients (n=7, four female, mean age 42 years) were prospectively recruited from 2008 to 2012. QoL scores were self-administered and obtained at baseline, 24 and 48 weeks postimplantion. WVF and TSS were assessed similarly. Health care usage, measured as hospitalization frequency and medication cost, was obtained six and 12 months before and after implant. Changes from baseline to six and 12 months for all outcomes were compared.
The mean ( ± SD) QoL according to EuroQol was significantly better at 24 weeks after the baseline measurement (baseline 29 ± 5, 24 weeks 52 ± 7; P = 0.03). The mean improvement in TSS was significantly better at one year postintervention (baseline score 35 ± 5 versus 12 months 27 ± 3; P = 0.03). Changes in Short-Form 36 Health Survey and WVF were not significant. Days of GP-related hospitalization were highly variable but decreased from a median of 71 days (range 0 to 227 days) to 29 days (range two to 334 days) one year before and after surgery, respectively (P = 0.735). Outpatient medication costs did not decrease to a significant extent.
Gastric neurostimulation for diabetic GP appeared to show some beneficial palliative effects overall in the present small open-label series, but the effect is highly variable among patients, and placebo effect cannot be ruled out.
胃神经刺激疗法治疗糖尿病胃轻瘫（GP）的疗效在加拿大的“真实环境”中尚未得到评估。
评估胃神经刺激器植入前后 12 个月内糖尿病 GP 患者的健康相关生活质量（QoL）、每周呕吐频率（WVF）、总症状评分（TSS）和医疗保健利用情况的变化。
2008 年至 2012 年期间，前瞻性招募了 7 名药物难治性糖尿病 GP 患者（4 名女性，平均年龄 42 岁）。在基线、植入后 24 周和 48 周时，患者自行进行 QoL 评分。WVF 和 TSS 也采用类似的方法进行评估。通过在植入前 6 个月和 12 个月时获取住院频率和药物成本来衡量医疗保健的使用情况。比较所有结局从基线到 6 个月和 12 个月的变化。
根据 EuroQol，24 周后 QoL 评分（基线时 29 ± 5，24 周时 52 ± 7；P = 0.03）显著改善。干预后 1 年 TSS 平均改善显著（基线评分 35 ± 5，12 个月时 27 ± 3；P = 0.03）。Short-Form 36 健康调查和 WVF 的变化无显著意义。GP 相关住院天数变化较大，但分别从手术前 1 年的中位数 71 天（范围 0 至 227 天）降至手术后 1 年的 29 天（范围 2 至 334 天）（P = 0.735）。门诊药物费用没有显著降低。
在本小型开放标签系列研究中，胃神经刺激术治疗糖尿病 GP 似乎总体上显示出一些有益的姑息效果，但在患者中效果差异很大，不能排除安慰剂效应。
