胃起搏对胃动力障碍患者胃肌电活动和胃排空的影响

目的　观察体表胃起搏对胃动力障碍患者的疗效。方法　选择具有胃动力障碍症状的患者 2 1例 ,其中15例为动力障碍型功能性消化不良 ,6例为糖尿病胃轻瘫。采用WCH型胃肠起搏仪进行胃起搏治疗 ,每日 1次 ,每次3 0min ,共 14日。比较治疗前后临床症状评分、体表胃电图参数及胃对不透X线标志物的排空率。结果　胃起搏治疗可改善患者临床症状 ,治疗前症状总积分为 6.70± 2 .17分 ,治疗后降为 3 .40± 2 .44分 (P <0 .0 1) ;治疗后总症状改善率为5 2 .3 %± 19.2 % ;对早饱、上腹胀的有效率分别为 70 .1%和 83 .3 %。胃起搏治疗可改善部分胃电参数 ,治疗后胃正常慢波百分比、主频与治疗前相比明显上升 (P <0 .0 5 )。胃起搏治疗还可提高患者的 4h胃内钡条排空率 ,有效率为 5 7.1%。无不良反应发生。结论　采用适宜的起搏参数从体表输入起搏信号治疗胃动力障碍患者 ,可缓解患者的临床症状 ,改善部分胃电参数 ,提高胃排空功能。

Effects of gastric pacing on gastric myoelectrical activity and gastric emptying in patients with gastric dysmotility

Objective To explore effects of gastric pacing on patients with gastric dysmotility. Methods According to symptoms of gastric dysmotility, 15 patients with dysmotility-like functional dyspepsia and 6 patients with diabetes gastroparesis were chosen to participate in the study. Using the WCH gastric pacing instrument, the treatment was performed 30 min per day for 14 days before meal in order to investigate the scoreof the clinical symptoms?gastric emptying and EGG before and after pacing. Results Gastric pacing improved the clinical symptoms of patients. The total scores of the clinical symptoms before and after the treatment was 6.70±2.17 and 3.40±2.44, respectively ( P <0.01); the rate of the totalsymptoms improvement after the treatment was 52.3±19.2%; the effective rate ofearly satiety and abdominal distention were 70.1% and 83.3%, respectively. Gastric pacing can improve gastric dysrhythmias. Compared with that before pacing, the percentage of normal gastric slow ware and dominant frequency of EGG raised obviously after pacing ( P <0.05). Gastric pacing can improve gastric emptyingrate, the effective rate was 57.1%. No side effects was found. Conclusion Using the optimal pacing parameters, surfaces gastric pacing isable to treat the patients with gastric dysmotility, which may improve clinicalsymptoms?gastric myoelectrical parameters and gastric emptying.