Anatomy and physiology of the gastroesophageal junction
Anatomy and physiology of the gastroesophageal junction
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DOI：
10.1016/s0889-8553(05)70307-1
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发表时间：
1997-09-01
影响因子：
3.7
通讯作者：
Kahrilas, PJ
中科院分区：
文献类型：
--
作者：
Kahrilas, PJ
胃食管交界处是一个复杂的瓣膜，由一个平滑肌元件（LES）和一个平滑肌元件组成。这些通常相互补充，以保持在静态条件下的能力，并在动态应力与增加腹内压或吞咽。这些括约肌成分也在病理生理上相互作用。在吞咽过程中，大的疝损害食管排空的过程，从而延长酸清除。在LES压力降低期间固有的对应激反流的易感性也通过使括约肌失能而显著增加。这些与食管裂孔疝相关的胃食管连接处的功能障碍导致食管酸暴露增加，并为反流病的慢性化提供了一种解释。
The gastroesophageal junction is a complex valve composed of a smooth muscle element (LES) and a diaphragmatic element. These normally supplement each other to maintain competence in a static condition and during dynamic stresses associated with increased intra-abdominal pressure or swallowing. These sphincteric components also interact with each other pathophysiologically. During swallowing, large hernias impair the process of esophageal emptying, thereby prolonging acid clearance. The susceptibility to stress reflux inherent during periods of diminished LES pressure is also dramatically increased by disabling the diaphragmatic sphincter. These functional impairments of the gastroesophageal junction associated with hiatus hernia lead to increased esophageal acid exposure and offer one explanation for the chronicity of reflux disease.