摘要
目的使用高分辨率固态测压系统验证不同体积的食团对健康受试者咽部推动力及食道上括约肌（UES）松弛功能的影响。方法健康受试者24例，均分别口服3种性状（水、浓流质、糊状食物）的食团，且每种食团分为3ml、5ml、10ml的体积。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体积对这些参数的影响。结果受试者吞咽水与浓流质时，UES的松弛残余压随食团体积的增加而降低[3ml浓流质（-1．71±0．94）mmHg，10ml浓流质（-4．68±1．92）mmHg]，松弛持续时间随食团体积的增加而延长[3ml浓流质（590．45±157．85）ms，10ml浓流质（702．49±124．53）ms]；咽部峰值压随食团体积的增加而升高[3ml浓流质（169．91±74．32）mmHg，10ml浓流质（204．42±91．28）mmHg]，而咽部收缩时间反而有所下降（P〈0．05）。吞咽糊状食物时，随食团体积的增加UES的松弛残余压（P〉0．05）及咽部收缩峰值（P〉0．05）无显著变化，而UES松弛持续时间延长。结论食物的体积对吞咽功能的不同参数如咽部收缩峰值压，咽部收缩持续时间，UES松弛残余压、UES松弛持续时间等影响也不同，食物体积的增加需要咽部和UES更多的能耗。
Objective To observe the effects of bolus volume on pharyngeal and upper esophageal sphinc- ter pressures and durations in healthy volunteers by using high-resolution manometry （ HRM）. Methods Twenty- four health subjects were recruited and asked to swallow three volumes of bolus （3 ml, 5 ml and 10 ml） in the neu- tral head position. Pressure and duration measurements were acquired by utilizing a high-resolution solid-state ma- nometer, with an emphasis on the hypopharynx and upper esophageal sphincter （UES）. Variables including UES residual pressure, UES relaxation duration, maximum hypopharygeal pressure and hypopharyngeal pressure duration were analyzed across bolus volumes and consistencies by using three-way repeated measures analysis of variance （ANOVA） to investigate influence of bolus volume. Results UES residual pressure [ - 1.71 mmHg（3 ml thick liquid）vs. -4.68 mmHg（ 10 ml thick liquid） ] , UES relaxation duration[590.45 ms（3 ml thick liquid） vs. 702.49 ms （ 10 ml thick liquid） ] , maximum hypopharygeal pressure [ 169. 91 mmHg （ 3 ml thick liquid） vs. 204.42 mmHg （10 ml thick liquid） I and hypopharyngeal pressure duration（ P 〈 0.05 ） varied significantly across bolus volumes when swallowing water or thick liquid. The UES relaxation duration, UES residual pressure and max- imum hypopharyngeal pressure had a direct positive relationship with bolus volume. There was significant differ- ences with regard to UES relaxation duration [685.75 ms（3 ml paste）vs. 772.27 ms （10 ml paste）] but not to UES residual pressure （ P 〉 0.05 ） and maximum hypopharyngeal pressure （ P 〉 0.05 ） across bolus volume when swallowing paste. Conclusions Difference in hypopharyngeal pressure and duration, UES residual pressure and duration were detected across varying bolus volumes. Consideration of these variables is paramount in understanding normal and pathological swallowing.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2013年第10期763-767,共5页
Chinese Journal of Physical Medicine and Rehabilitation
基金
国家自然科学基金面上项目（81371441）
国家自然科学基金青年基金（81101460）
广州市科技计划项目对外科技合作专项（2012J5100022）
中央高校基本科研业务费专项资金（12ykpy38）
关键词
体积
吞咽
吞咽生理
高分辨率测压
Bolus volume
Deglutition
Swallowing physiology
High-resolution manometry
