Petrakis J, Vassilakis J S, Karkavitsas N, Tzovaras G, Epanomeritakis E, Tsiaoussis J, Xynos E
Department of General Surgery, University Hospital of Heraklion, Medical School, University of Crete, Greece.
Arch Surg. 1998 Jul;133(7):709-14. doi: 10.1001/archsurg.133.7.709.
Roux-en-Y reconstruction is sometimes associated with symptoms that suggest food stasis, as a result of dysmotility of either the gastric remnant and/or the efferent jejunal limb.
To study the possible effect of intravenous erythromycin lactobionate on gastric emptying of solids in patients who have undergone a Roux-en-Y procedure.
Twenty-four patients with a Roux-en-Y procedure participated in the study. Ten of them had undergone truncal vagotomy with pyloroplasty; the remaining 14 had undergone a Billroth II subtotal gastrectomy as the initial antiulcer procedure. Sixteen healthy subjects served as controls.
All healthy subjects and patients underwent assessment of gastric emptying of a standard radiolabeled solid meal after administration of placebo or 200 mg of erythromycin lactobionate intravenously. Scanning was done with a gamma camera, and emptying curves were constructed. From these curves the half-time of gastric emptying was calculated.
Patients with severe symptoms of gastric stasis had a significantly longer half-time than did patients with mild or no symptoms (P=.002). Patients with a Billroth II subtotal gastrectomy as the initial antiulcer procedure had a significantly worse grade of symptoms (P=.01) and a significantly prolonged half-time (P=.02) compared with patients with a truncal vagotomy with pyloroplasty as the initial antiulcer procedure. Erythromycin significantly reduced the half-time in the controls (P<.001) and all patients after Roux-en-Y procedure (P<.001).
Erythromycin could be a useful prokinetic drug in patients with Roux stasis syndrome.
由于胃残余部和/或空肠输出袢动力障碍，Roux-en-Y重建术有时会伴有提示食物淤滞的症状。
研究静脉注射乳糖酸红霉素对接受Roux-en-Y手术患者固体食物胃排空的可能影响。
24例接受Roux-en-Y手术的患者参与了本研究。其中10例接受了迷走神经切断术加幽门成形术；其余14例最初接受了毕Ⅱ式胃大部切除术作为抗溃疡手术。16名健康受试者作为对照。
所有健康受试者和患者在静脉注射安慰剂或200mg乳糖酸红霉素后，接受标准放射性标记固体餐胃排空评估。用γ相机进行扫描，并绘制排空曲线。根据这些曲线计算胃排空半衰期。
有严重胃淤滞症状的患者半衰期明显长于症状轻微或无症状的患者（P = 0.002）。与最初接受迷走神经切断术加幽门成形术作为抗溃疡手术的患者相比，最初接受毕Ⅱ式胃大部切除术作为抗溃疡手术的患者症状分级明显更差（P = 0.01），半衰期明显延长（P = 0.02）。红霉素显著缩短了对照组的半衰期（P < 0.001）以及Roux-en-Y手术后所有患者的半衰期（P < 0.001）。
红霉素可能是治疗Roux淤滞综合征患者的一种有用的促动力药物。
