Abstract：
OBJECTIVE: We explored factors affecting gastric emptying in neurologically impaired (NI) patients using the 13C-acetate breath test.
METHODS: Twenty-four NI patients were classified by the presence of gastroesophageal reflux disease (GERD), which was treated by fundoplication plus gastrostomy, or the absence of GERD, which was treated by gastrostomy alone, along with gastric malposition involving cascade stomach and organoaxial gastric volvulus (OGV). Gastric emptying parameters (GEPs), which were the emptying half time (T 1/2 , minute), the lag phase time (T lag , minute), and the gastric emptying coefficient (GEC), were measured before and after surgery. We evaluated the relationship between GEPs and GERD, gastric malposition, and surgical intervention. All data were expressed as the median (interquartile range).
RESULTS: The T1/2 and GEC of patients with OGV were significantly worse than in those without OGV before surgery (T1/2 with OGV: 241.3 [154.9, 314.3] vs. T1/2 without OGV: 113.7 [105.2, 151.4], p = 0.01, GEC with OGV: 3.19 [2.46, 3.28] vs. GEC without OGV: 3.65 [3.24, 3.90], p = 0.02). GERD and cascade stomach were not associ ated with GEPs. The GEPs of all NI patients showed no significant difference between before and after surgery. The surgical change in T1/2 (ΔT 1/2 ) in the patients with OGV was significantly lower than in those without OGV (ΔT1/2 with OGV: -47.1 [-142.7, -22.1] vs. ΔT1/2 without OGV: -3.78 [-26.6, 12.0], p = 0.03).
CONCLUSIONS: Stomach malposition, such as OGV, seems to affect gastric emptying and may be improved by surgi cal intervention.
METHODS: Twenty-four NI patients were classified by the presence of gastroesophageal reflux disease (GERD), which was treated by fundoplication plus gastrostomy, or the absence of GERD, which was treated by gastrostomy alone, along with gastric malposition involving cascade stomach and organoaxial gastric volvulus (OGV). Gastric emptying parameters (GEPs), which were the emptying half time (T 1/2 , minute), the lag phase time (T lag , minute), and the gastric emptying coefficient (GEC), were measured before and after surgery. We evaluated the relationship between GEPs and GERD, gastric malposition, and surgical intervention. All data were expressed as the median (interquartile range).
RESULTS: The T1/2 and GEC of patients with OGV were significantly worse than in those without OGV before surgery (T1/2 with OGV: 241.3 [154.9, 314.3] vs. T1/2 without OGV: 113.7 [105.2, 151.4], p = 0.01, GEC with OGV: 3.19 [2.46, 3.28] vs. GEC without OGV: 3.65 [3.24, 3.90], p = 0.02). GERD and cascade stomach were not associ ated with GEPs. The GEPs of all NI patients showed no significant difference between before and after surgery. The surgical change in T1/2 (ΔT 1/2 ) in the patients with OGV was significantly lower than in those without OGV (ΔT1/2 with OGV: -47.1 [-142.7, -22.1] vs. ΔT1/2 without OGV: -3.78 [-26.6, 12.0], p = 0.03).
CONCLUSIONS: Stomach malposition, such as OGV, seems to affect gastric emptying and may be improved by surgi cal intervention.
摘要：
目的：我们使用13C-乙酸呼气试验探索了影响神经系统受损（NI）患者胃排空的因素。
方法：根据胃食管反流病（GERD）对24例NI患者进行分类，通过胃底折叠术和胃造口术治疗，或者没有GERD，仅通过胃造口术治疗，伴随着涉及级联胃和有机轴性胃扭转（OGV）的胃错位。胃排空参数(GEP),这是排空的一半时间(T1/2，分钟),滞后相位时间(T滞后，分钟),和胃排空系数（GEC），在手术前后进行测量。我们评估了GEPs和GERD之间的关系，胃错位,和手术干预。所有数据表示为中值(四分位距)。
结果：手术前OGV患者的T1/2和GEC明显低于无OGV患者（OGV的T1/2：241.3[154.9，314.3]vs.无OGV的T1/2:113.7[105.2,151.4],p=0.01，具有OGV的GEC：3.19[2.46，3.28]vs.无OGV的GEC：3.65[3.24，3.90]，p=0.02)。GERD和级联胃与GEP无关。所有NI患者的GEP在手术前后无明显差异。OGV患者的T1/2（ΔT1/2）的手术变化明显低于无OGV患者（OGV的ΔT1/2：-47.1[-142.7，-22.1]vs.无OGV的ΔT1/2：-3.78[-26.6,12.0]，p=0.03)。
结论：胃错位，比如OGV,似乎会影响胃排空，并可能通过手术干预得到改善。
方法：根据胃食管反流病（GERD）对24例NI患者进行分类，通过胃底折叠术和胃造口术治疗，或者没有GERD，仅通过胃造口术治疗，伴随着涉及级联胃和有机轴性胃扭转（OGV）的胃错位。胃排空参数(GEP),这是排空的一半时间(T1/2，分钟),滞后相位时间(T滞后，分钟),和胃排空系数（GEC），在手术前后进行测量。我们评估了GEPs和GERD之间的关系，胃错位,和手术干预。所有数据表示为中值(四分位距)。
结果：手术前OGV患者的T1/2和GEC明显低于无OGV患者（OGV的T1/2：241.3[154.9，314.3]vs.无OGV的T1/2:113.7[105.2,151.4],p=0.01，具有OGV的GEC：3.19[2.46，3.28]vs.无OGV的GEC：3.65[3.24，3.90]，p=0.02)。GERD和级联胃与GEP无关。所有NI患者的GEP在手术前后无明显差异。OGV患者的T1/2（ΔT1/2）的手术变化明显低于无OGV患者（OGV的ΔT1/2：-47.1[-142.7，-22.1]vs.无OGV的ΔT1/2：-3.78[-26.6,12.0]，p=0.03)。
结论：胃错位，比如OGV,似乎会影响胃排空，并可能通过手术干预得到改善。
