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首页> 外文期刊>Current treatment options in gastroenterology >Advances in the management of gastroparesis.
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Advances in the management of gastroparesis.

机译：胃轻瘫的管理进展。

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The treatment goals for patients with gastroparesis are to control symptoms; to correct fluid, electrolyte, and nutritional deficiencies; and to identify and treat the underlying cause of gastroparesis. For mild symptoms, dietary modifications and a low-dose antiemetic and/or prokinetic agent might provide satisfactory control of symptoms. Dietary treatments include decreasing the solid food component while increasing the liquid nutrient component of meals. Fat and fiber intake should be minimized. Metoclopramide, despite its potential for neurological side effects, remains a prokinetic treatment for symptomatic patients. In patients with diabetic gastroparesis, careful regulation of glycemic control may help to reduce symptoms. Medical management of patients with gastroparesis who do not respond to initial antiemetic or prokinetic therapy or who develop medication-related side effects involves the use of other prokinetic and antiemetic agents with different mechanisms of action. Combinations of prokinetic and antiemetic agents often are tried in patients with persistent symptoms. In some patients with persistent refractory symptoms and failure to maintain adequate fluid and/or nutritional intake, bypassing the stomach with jejunostomy feedings may be necessary. Gastric electrical stimulation is a treatment for refractory gastroparesis. Based on initial studies showing symptom benefit, especially in patients with diabetic gastroparesis, gastric electrical stimulation was granted humanitarian US Food and Drug Administration approval for the treatment of chronic, refractory nausea and vomiting secondary to idiopathic or diabetic gastroparesis. However, which patients are likely to respond, the optimal electrode position, and the optimal stimulation parameters remain areas that need to be addressed.
机译：胃轻瘫患者的治疗目标是控制症状。纠正体液，电解质和营养不足;并找出和治疗胃轻瘫的根本原因。对于轻度症状，饮食调整和小剂量止吐药和/或促运动剂可能会提供令人满意的症状控制。饮食治疗包括减少固体食物成分，同时增加膳食中的液体营养成分。脂肪和纤维的摄入量应降至最低。甲氧氯普胺尽管具有潜在的神经学副作用，但仍是有症状患者的促运动疗法。在糖尿病性胃轻瘫患者中，仔细调节血糖控制可能有助于减轻症状。对最初的止吐药或促动力疗法无反应或出现药物相关副作用的胃轻瘫患者的医疗管理包括使用其他作用机理不同的促动力药和止吐药。患有持续症状的患者通常尝试使用促动药和止吐药的组合。在一些持续顽固症状且无法维持足够的液体和/或营养摄入的患者中，可能需要通过空肠造口术绕过胃。胃电刺激是难治性胃轻瘫的一种治疗方法。基于显示症状获益的初步研究，尤其是在糖尿病性胃轻瘫患者中，胃电刺激被美国食品药品管理局批准用于治疗慢性，难治性恶心和继发于特发性或糖尿病性胃轻瘫的呕吐。但是，哪些患者可能会做出反应，最佳电极位置和最佳刺激参数仍然是需要解决的领域。

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