I. Sarosiek, Alexandra N. Willauer, Karina Espino, J. Sarosiek, G. Galura, Luis Alvarado, A. Dwivedi, Brian Davis, M. Bashashati, Richard McCallum
{"title":"胃肠电刺激疗法用于长期控制胃痉挛患者症状的最佳参数","authors":"I. Sarosiek, Alexandra N. Willauer, Karina Espino, J. Sarosiek, G. Galura, Luis Alvarado, A. Dwivedi, Brian Davis, M. Bashashati, Richard McCallum","doi":"10.3390/gidisord6020037","DOIUrl":null,"url":null,"abstract":"Background: Gastric electrical stimulation (GES) therapy is indicated for the treatment of drug-refractory gastroparesis (GP). However, the long-term effects of GES therapy on GP symptom control and identification of the optimal parameters to activate this long-term efficacy have not been investigated. Methods: We conducted a retrospective cohort analysis of 57 GP patients who received GES and pyloroplasty (PP). The interrogation of the GES system and assessment of GP symptoms were conducted at the initiation of GES therapy and during follow-up visits. We determined the changes in GES parameters including voltage (V), impedance (I), and current (C). The outcome was total symptom score (TSS), which was measured by self-reported GP symptoms. Results: The mean age of patients was 44 (±14) years, and 72% were females. The etiology for GP was diabetes mellitus in 72% and idiopathic in 28%. The median duration of GES follow-up was 47 months (range 5–73) A significant decrease was found in individual symptom scores and the TSS (−10.8; 95%CI: −12.6, −9.08) compared to baseline scores (p < 0.0001). During follow-up, readings for I (515 vs. 598 Ω), V (3.3 vs. 4.8 V), and C (6.5 vs. 8.4 mA) significantly increased (p ≤ 0.0001 for all parameters). Higher GES settings were associated with lower TSS in the adjusted analysis (RC, −1.97; 95%CI: −3.81, −0.12, p = 0.037). Conclusions: these findings suggest that adjusting GES parameters over time based on optimizing symptom improvement should be incorporated into the long-term care of patients receiving gastric neurostimulation therapy.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimal Parameters for Gastric Electrical Stimulation Therapy for Long-Term Symptom Control in Patients with Gastroparesis\",\"authors\":\"I. Sarosiek, Alexandra N. Willauer, Karina Espino, J. Sarosiek, G. Galura, Luis Alvarado, A. Dwivedi, Brian Davis, M. Bashashati, Richard McCallum\",\"doi\":\"10.3390/gidisord6020037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Gastric electrical stimulation (GES) therapy is indicated for the treatment of drug-refractory gastroparesis (GP). However, the long-term effects of GES therapy on GP symptom control and identification of the optimal parameters to activate this long-term efficacy have not been investigated. Methods: We conducted a retrospective cohort analysis of 57 GP patients who received GES and pyloroplasty (PP). The interrogation of the GES system and assessment of GP symptoms were conducted at the initiation of GES therapy and during follow-up visits. We determined the changes in GES parameters including voltage (V), impedance (I), and current (C). The outcome was total symptom score (TSS), which was measured by self-reported GP symptoms. Results: The mean age of patients was 44 (±14) years, and 72% were females. The etiology for GP was diabetes mellitus in 72% and idiopathic in 28%. The median duration of GES follow-up was 47 months (range 5–73) A significant decrease was found in individual symptom scores and the TSS (−10.8; 95%CI: −12.6, −9.08) compared to baseline scores (p < 0.0001). During follow-up, readings for I (515 vs. 598 Ω), V (3.3 vs. 4.8 V), and C (6.5 vs. 8.4 mA) significantly increased (p ≤ 0.0001 for all parameters). Higher GES settings were associated with lower TSS in the adjusted analysis (RC, −1.97; 95%CI: −3.81, −0.12, p = 0.037). Conclusions: these findings suggest that adjusting GES parameters over time based on optimizing symptom improvement should be incorporated into the long-term care of patients receiving gastric neurostimulation therapy.\",\"PeriodicalId\":507842,\"journal\":{\"name\":\"Gastrointestinal Disorders\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastrointestinal Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3390/gidisord6020037\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastrointestinal Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/gidisord6020037","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景:胃电刺激疗法(GES)适用于治疗药物难治性胃瘫(GP)。然而,GES疗法对GP症状控制的长期效果以及激活这种长期疗效的最佳参数尚未得到研究。方法:我们对 57 名接受 GES 和幽门成形术 (PP) 的 GP 患者进行了回顾性队列分析。在开始接受 GES 治疗时和随访期间,我们对 GES 系统进行了检查,并对 GP 症状进行了评估。我们测定了 GES 参数的变化,包括电压 (V)、阻抗 (I) 和电流 (C)。治疗结果为症状总分(TSS),通过自我报告的 GP 症状进行测量。研究结果患者平均年龄为 44(±14)岁,72% 为女性。72%患者的GP病因为糖尿病,28%为特发性。GES 随访时间的中位数为 47 个月(5-73 个月)。与基线分数相比,单个症状分数和 TSS(-10.8;95%CI:-12.6,-9.08)均有显著下降(p < 0.0001)。在随访期间,I(515 vs. 598 Ω)、V(3.3 vs. 4.8 V)和C(6.5 vs. 8.4 mA)读数显著增加(所有参数的 p 均小于 0.0001)。在调整分析中,较高的 GES 设置与较低的 TSS 相关(RC,-1.97;95%CI:-3.81,-0.12,p = 0.037)。结论:这些研究结果表明,在接受胃神经刺激治疗的患者的长期护理中,应根据症状改善的最佳情况逐步调整 GES 参数。
Optimal Parameters for Gastric Electrical Stimulation Therapy for Long-Term Symptom Control in Patients with Gastroparesis
Background: Gastric electrical stimulation (GES) therapy is indicated for the treatment of drug-refractory gastroparesis (GP). However, the long-term effects of GES therapy on GP symptom control and identification of the optimal parameters to activate this long-term efficacy have not been investigated. Methods: We conducted a retrospective cohort analysis of 57 GP patients who received GES and pyloroplasty (PP). The interrogation of the GES system and assessment of GP symptoms were conducted at the initiation of GES therapy and during follow-up visits. We determined the changes in GES parameters including voltage (V), impedance (I), and current (C). The outcome was total symptom score (TSS), which was measured by self-reported GP symptoms. Results: The mean age of patients was 44 (±14) years, and 72% were females. The etiology for GP was diabetes mellitus in 72% and idiopathic in 28%. The median duration of GES follow-up was 47 months (range 5–73) A significant decrease was found in individual symptom scores and the TSS (−10.8; 95%CI: −12.6, −9.08) compared to baseline scores (p < 0.0001). During follow-up, readings for I (515 vs. 598 Ω), V (3.3 vs. 4.8 V), and C (6.5 vs. 8.4 mA) significantly increased (p ≤ 0.0001 for all parameters). Higher GES settings were associated with lower TSS in the adjusted analysis (RC, −1.97; 95%CI: −3.81, −0.12, p = 0.037). Conclusions: these findings suggest that adjusting GES parameters over time based on optimizing symptom improvement should be incorporated into the long-term care of patients receiving gastric neurostimulation therapy.