Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
Neurogastroenterol Motil. 2018 Dec;30(12):e13453. doi: 10.1111/nmo.13453. Epub 2018 Aug 23.
There is a clear need for a novel method to readily assess gastric motility in daily clinical practice.
In a crossover design, 10 noncompliant balloons of different shape and volume (25-350 mL), attached to a classic feeding tube, were introduced in the stomach of eight healthy volunteers. In the same experiment, a High-Resolution Manometry (HRM) catheter was positioned throughout the stomach. Gastric motility was recorded during fasting (2 hours) and liquid nutrient administration (30 minutes). Motility was quantified using a peak detection algorithm. Symptoms were recorded throughout the experiment using visual analog scales (100 mm). Results are presented as mean ± SD.
The % time during which motility-induced pressure increments could be detected with HRM but not by the balloon varied from 42 ± 24% in the smallest (25 mL) balloon to 1 ± 1% in the 330 mL balloon. On the other hand, bloating, discomfort and nausea scores were 0 ± 0, 0 ± 0 and 2 ± 5 mm, respectively, for the smallest balloon (25 mL) while these scores were 28 ± 38, 13 ± 30, and 38 ± 30 mm, respectively, for the largest balloon (350 mL). A phase III contraction pattern was consistently evoked in balloons with a volume >200 mL.
Gastric motility could be assessed more accurately with larger volume balloons, while epigastric symptoms were evoked with increasing balloon volume. The optimal balloon to measure gastric motility has a 5 cm diameter and is 11 cm long (210 mL). A nasogastric balloon catheter can now be developed that enables relatively easy monitoring of gastric motility in patients with epigastric symptoms.
目前，我们迫切需要一种新的方法来在日常临床实践中快速评估胃动力。
在一项交叉设计中，将 10 个不同形状和体积（25-350ml）的非顺应性气球附着在经典的喂养管上，引入 8 名健康志愿者的胃中。在相同的实验中，将高分辨率测压（HRM）导管放置在整个胃中。在空腹（2 小时）和液体营养物质输注（30 分钟）期间记录胃动力。使用峰值检测算法对动力进行定量。使用视觉模拟量表（100mm）在整个实验过程中记录症状。结果表示为平均值±标准差。
通过 HRM 可以检测到动力引起的压力增量的时间百分比而不能通过气球检测到的时间百分比，从小的（25ml）气球的 42±24%变化到 330ml 气球的 1±1%。另一方面，最小的（25ml）气球的腹胀、不适和恶心评分分别为 0±0、0±0 和 2±5mm，而最大的（350ml）气球的评分分别为 28±38、13±30 和 38±30mm。对于体积大于 200ml 的气球，始终会诱发 III 相收缩模式。
使用更大体积的气球可以更准确地评估胃动力，而随着气球体积的增加，上腹部症状会被诱发。测量胃动力的最佳气球的直径为 5cm，长 11cm（210ml）。现在可以开发一种鼻胃气球导管，使患有上腹部症状的患者能够相对容易地监测胃动力。
