高分辨率固态测压系统用于研究不同黏稠度食团对健康人咽部及食道上括约肌功能的影响

关键词：黏稠度  吞咽  吞咽生理  高分辨率测压

Keywords:consistency  deglutition  swallowing physiology  high-resolution manometry

摘要：

      摘要 目的: 使用高分辨率固态测压系统检查不同黏稠度的食团对咽部推动力及食管上括约肌（UES)松弛功能的影响。 方法：24个健康志愿者分别给予三种不同黏稠度（水、浓流质、糊状）的食团。吞咽过程中的咽部及UES压力与收缩/松弛持续时间的测量均由高分辨率固态测压系统完成。测量的参数包括：咽部收缩峰值压，咽部收缩持续时间，UES松弛残余压，UES松弛持续时间。使用重复测量的方差分析研究食团黏稠度对这些参数的影响。 结果：吞咽3ml食团时，随食物黏稠度的增加，UES的松弛残余压进一步降低，UES松弛持续时间不断延长，咽部峰值压不断升高，咽部收缩持续时间也逐渐延长。吞咽10ml食团时， UES的松弛残余压、松弛持续时间与吞咽3ml食团时类似，但咽部峰值压及收缩持续时间变化不大。 结论：随着食团黏稠度的增加，UES的松弛时间延长及残余压下降。在吞咽容积较小的食团时，依靠咽部推动及UES松弛功能均增强，克服黏稠度增加产生的阻力。而在吞咽容积较大的食团时，主要依靠UES增加松弛程度，吸引食团向下运送，克服黏稠度增加产生的阻力。

Abstract:

      Abstract Objective:To explore the effect of food bolus of different consistency on function of pharyngeal and upper esophageal sphincter(UES) using high-resolution solid state manometry (HRM). Method:Twenty-four health subjects swallowed three kinds of bolus of different consistencies (water，thick，pasty) with neutral head position during sitting. Pressure and contraction/relax durations measurements were performed using HRM, with emphasis placed on hypopharynx and UES. Variables include UES residual pressure, UES relaxation duration, maximum hypopharygeal pressure and hypopharyngeal duration were repeatedly measured and analyzed across different volumes and consistencies of bolus. Result:UES residual pressure, UES relaxation duration, maximum hypopharyngeal pressure and hypopharyngeal duration varied significantly across different bolus consistencies. UES relaxation duration, UES residual pressure and maximum hypopharyngeal pressure, had a direct positive relationship with bolus consistency. Conclusion:Differences in hypopharyngeal pressure and duration, UES residual pressure and duration could be detected across varying bolus consistencies. Consideration of these variables was paramount in understanding normal and pathological swallowing.