el-Amir N G, Gardocki M, Levin H R, Markowitz D D, Greenspan R L, Catanese K A, Rose E A, Oz M C
Department of Surgery, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA.
ASAIO J. 1996 May-Jun;42(3):150-3.
Left ventricular assist devices effectively improve hemodynamic function and reverse renal and hepatic dysfunction; however, their effects upon the gastrointestinal (Gl) system have not been addressed. We evaluated Gl function in 27 left ventricular assist device recipients using interviews, Gl contrast studies, endoscopy, and 99mTc sulfur colloid studies of esophageal transit and gastric emptying. While on left ventricular assist device support (mean duration of 84 days), 19 patients reported early satiety and/or nausea, and 1 was unable to tolerate oral intake. Esophageal transit time (normal, < 10 sec) was borderline slow at 14 +/- 4 (mean +/- standard error of the mean) and gastric emptying (normal < 90 min) was prolonged (range of 106-506 min, mean = 283 +/- 69 min). In a 1-38 month follow-up, gastric function subjectively improved in all. Six patients had intraperitoneal device placement. One died of aspiration pneumonia secondary to small bowel obstruction, and one had prolonged inability to tolerate oral intake, which required feeding jejunostomy tube placement. The 21 patients with pre peritoneal placement of the device did not require Gl operative interventions and had no catastrophic Gl events; they had mild to no Gl complaints. Pre peritoneal placement may mitigate early satiety and obviate serious Gl complications.
左心室辅助装置可有效改善血流动力学功能，并逆转肾和肝功能障碍；然而，其对胃肠道系统的影响尚未得到研究。我们通过访谈、胃肠道造影研究、内镜检查以及用99m锝硫胶体进行食管通过和胃排空研究，对27例左心室辅助装置接受者的胃肠道功能进行了评估。在接受左心室辅助装置支持期间（平均持续时间84天），19例患者报告有早饱感和/或恶心，1例无法耐受经口摄入。食管通过时间（正常，<10秒）在14±4秒（均值±均值标准误）时接近缓慢，胃排空时间（正常<90分钟）延长（范围为106 - 506分钟，平均 = 283±69分钟）。在1 - 38个月的随访中，所有患者的胃功能主观上均有改善。6例患者进行了腹腔内装置植入。1例死于小肠梗阻继发的吸入性肺炎，1例长期无法耐受经口摄入，需要放置空肠造瘘喂养管。21例装置植入于腹膜前的患者无需进行胃肠道手术干预，也未发生严重的胃肠道事件；他们仅有轻度或无胃肠道不适。腹膜前植入可能减轻早饱感并避免严重的胃肠道并发症。
