Axelrod F B, Schneider K M, Ament M E, Kutin N D, Fonkalsrud E W
Ann Surg. 1982 Mar;195(3):253-8. doi: 10.1097/00000658-198203000-00002.
Gastric and esophageal dysfunction are components of familial dysautonomia. The limited success of various medical management programs, has led to two types of surgical intervention. Experience with nine patients who had gastrostomy alone and 12 patients who had gastroesophageal fundoplication is reviewed. Both surgical procedures decreased frequency of vomiting and pneumonias and had positive effects on weight gain. Although "dysautonomic crises" are not eliminated, sufficient modification in character occurs so that associated risks are lessened. It is suggested that if medical management cannot control recurrent pneumonia, postprandial vomiting, esophageal bleeding, and/or inadequate weight gain, then the patient should be evaluated for fundoplication and/or gastrostomy.
胃和食管功能障碍是家族性自主神经功能异常的组成部分。各种药物治疗方案的效果有限，因此出现了两种手术干预方式。本文回顾了9例仅接受胃造口术和12例接受胃食管胃底折叠术患者的治疗经验。两种手术均降低了呕吐和肺炎的发生率，并对体重增加有积极影响。虽然“自主神经危象”并未消除，但症状特征有了足够的改善，相关风险得以降低。建议如果药物治疗无法控制复发性肺炎、餐后呕吐、食管出血和/或体重增加不足，那么应对患者进行胃底折叠术和/或胃造口术评估。
