Campbell J R, Gilchrist B F, Harrison M W
Division of Pediatric Surgery, School of Medicine, Oregon Health Sciences University, Portland 97201.
J Pediatr Surg. 1989 Apr;24(4):375-7. doi: 10.1016/s0022-3468(89)80274-x.
Previous studies have suggested that delayed gastric emptying occurs in severely mentally retarded patients with gastroesophageal reflux. Based on this data, pyloroplasty was employed in such patients. A retrospective analysis of 99 consecutive patients who underwent primary fundoplication for GER was performed. Gastric emptying, as measured by successful removal of the nasogastric tube or elevation of the gastrostomy tube, was studied. Children with neurologic disorders had no clinically significant difference in gastric emptying after fundoplication (3.31 days) when compared with neurologically normal patients (2.21 days). When added to Nissen fundoplication, pyloroplasty did not hasten the return of gastrointestinal function in the severely impaired patients (4.91 days). A prospective study employing gastric isotope bolus feedings before and after Nissen fundoplication will determine if pyloroplasty improves gastric emptying when used in conjunction with Nissen fundoplication for patients with severe neurologic disorders.
以往研究表明，患有胃食管反流的重度智力迟钝患者会出现胃排空延迟。基于这些数据，此类患者采用了幽门成形术。对99例因胃食管反流接受初次胃底折叠术的连续患者进行了回顾性分析。通过成功拔除鼻胃管或抬高胃造瘘管来测量胃排空情况，并进行了研究。与神经功能正常的患者（2.21天）相比，患有神经疾病的儿童在接受胃底折叠术后胃排空情况无临床显著差异（3.31天）。对于重度受损患者，在nissen胃底折叠术基础上加做幽门成形术并未加快胃肠功能恢复（4.91天）。一项在nissen胃底折叠术前后采用胃同位素推注喂养的前瞻性研究将确定，对于患有严重神经疾病的患者，在与nissen胃底折叠术联合使用时，幽门成形术是否能改善胃排空。
