胃电刺激治疗难治性胃轻瘫：当前的管理方法。
Gastric Electrical Stimulation for Treatment of Refractory Gastroparesis: the Current Approach to Management.
机构信息
Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Division of Gastroenterology, Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
出版信息
Curr Gastroenterol Rep. 2021 Jan 22;23(2):2. doi: 10.1007/s11894-020-00803-0.
PURPOSE OF REVIEW
Gastroparesis is one of the more challenging entities in the landscape of gastroenterology, posing difficulties for both patients and physicians with regard to effective management and therapies. In this article, we reviewed various gastroparesis treatment options, with an emphasis on gastric electrical stimulation (GES).
RECENT FINDINGS
GES has demonstrated a significant reduction of cardinal symptoms in refractory gastroparetic patients, particularly nausea and vomiting, across multiple studies. However, GES has not been shown to conclusively decrease gastric emptying time in these patients. Such finding has led the investigators to analyze the impact of combining GES with pyloroplasty. While this treatment pathway is nascent, its results thus far reveal an amplified improvement of gastroparesis symptomatology in addition to significant reduction of gastric transit, compared to GES by itself. Limited treatment choices are available for refractory gastroparesis. Combining GES with pyloroplasty holds promise but requires further assessment in large-scale trials to fully evaluate the risks and benefits.
目的综述
胃轻瘫是消化内科领域更具挑战性的病症之一，无论对于患者还是医生，在有效管理和治疗方面都存在困难。本文综述了各种胃轻瘫治疗方法，重点介绍了胃电刺激（GES）。
最近的发现
多项研究表明，GES 可显著减轻难治性胃轻瘫患者的主要症状，尤其是恶心和呕吐。然而，GES 并未证实能明确缩短这些患者的胃排空时间。这一发现促使研究人员分析将 GES 与幽门成形术联合应用的效果。尽管这种治疗途径尚处于初始阶段，但迄今为止的结果表明，与单独使用 GES 相比，这种联合疗法除了显著减少胃传输时间外，还能显著改善胃轻瘫症状。对于难治性胃轻瘫，治疗选择有限。GES 与幽门成形术联合应用具有一定前景，但需要在大规模试验中进一步评估其风险和获益。
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