Camilleri M
Gastroenterology Research Unit, Mayo Clinic, Rochester, Minnesota.
Am J Gastroenterol. 1994 Oct;89(10):1769-74.
To evaluate the medium- and long-term treatment of patients with gastroparesis and chronic intestinal dysmotility (CID). This assessment is timely, inasmuch as several treatment trials have been published within the past 2 yr, necessitating an appraisal of the outcome of treatments.
Literature review based on Medline Search using key words: gastroparesis, chronic intestinal pseudo-obstruction, enteral nutrition, feeding jejunostomy, prokinetics, gastric atony, gastrectomy, Roux-Y gastrectomy.
Restoration of nutrition can be achieved orally, enterally, or parenterally, depending on the severity of the clinical syndrome. Combinations of antiemetics and prokinetics are useful for symptomatic and objective benefits. Intravenous erythromycin is chiefly beneficial in the acute presentation. The weight of current evidence favors cisapride as the prokinetic of choice in the medium and long term. Surgical approaches are restricted to providing a means for decompression, access to the small bowel for nutrition, and resection for localized disease or completion of gastrectomies for atony after gastric surgery.
More rational choices of access for nutritional supplementation, selection of prokinetic agents, and indications for surgical treatment can be made on the basis of clinical experience and published studies; however, several unanswered questions remain and call for further outcome-based studies in patients with gastroparesis and CID.
评估胃轻瘫和慢性肠道动力障碍（CID）患者的中长期治疗情况。鉴于过去2年内已发表了多项治疗试验，因此有必要对治疗结果进行评估，此次评估很及时。
基于Medline搜索进行文献综述，使用关键词：胃轻瘫、慢性肠道假性梗阻、肠内营养、空肠造口喂养、促动力药、胃无力、胃切除术、Roux-Y胃切除术。
根据临床综合征的严重程度，可通过口服、肠内或肠外途径恢复营养。止吐药和促动力药联合使用对缓解症状和获得客观疗效有益。静脉注射红霉素主要对急性发作有益。目前的证据表明，西沙必利是中长期促动力药的首选。手术方法仅限于提供减压手段、建立小肠营养通道以及对局部病变进行切除或在胃手术后对胃无力进行胃切除。
基于临床经验和已发表的研究，可以更合理地选择营养补充途径、促动力药以及手术治疗的适应证；然而，仍有几个未解决的问题，需要对胃轻瘫和CID患者进行进一步的基于结果的研究。
