UPPER ESOPHAGEAL SPHINCTER FUNCTION DURING DE-GLUTITION
UPPER ESOPHAGEAL SPHINCTER FUNCTION DURING DE-GLUTITION
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DOI：
10.1016/0016-5085(88)90290-9
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发表时间：
1988-07-01
期刊：
影响因子：
29.4
通讯作者：
SHAKER, R
中科院分区：
文献类型：
--
作者：
KAHRILAS, PJ;DODDS, WJ;SHAKER, R
对8名正常志愿者在吞咽分级容量时的上食管括约肌功能进行了研究。同时记录视频荧光镜和测压研究，并通过视频计时器相互关联。最大食管上括约肌（UES）压力通常位于下咽和括约肌近端边缘之间的空气-组织界面远端1.5 cm处。UES压力最大≥ 50%的区域平均长度为1.0 cm。因此，UES的生理高压区在大小和位置上与颅咽肌相对应。对括约肌运动的X线分析表明，在吞咽过程中，括约肌高压区经口移动2.0-2.5 cm，经口移动的幅度与吞咽的钡剂量直接相关。在吞咽过程中括约肌开口的最大前后直径范围为0.9至1.5厘米，也与吞咽量直接相关。UES打开和松弛的时间间隔随着推注量的增加而显著增加; UES松弛的持续时间范围从干吞咽的平均0.37 s到20 ml吞咽的平均0.65 s。因此，吞咽期间UES功能的动力学取决于吞咽丸剂的体积。更大的推注量通过增大括约肌开口直径和延长括约肌松弛间隔来调节。对咽部吞咽序列中其他参考点的时间分析表明，随着UES松弛的测压间期增加，喉部抬高的时间延长，UES松弛较早，收缩较晚，喉部抬高和下咽收缩的开始之间的时间间隔增加。
Upper esophageal sphincter function was investigated during swallows of graded volumes in 8 normal volunteers. Concurrent recordings of videofluoroscopic and manometric studies were obtained and correlated with each other by means of a videotimer. Maximal upper esophageal sphincter (UES) pressure was typically located 1.5 cm distal to the air-tissue interface between the hypopharynx and the proximal margin of the sphincter. The region in which UES pressure was .gtoreq.50% maximal averaged 1.0 cm in length. Thus, the physiologic high-pressure zone of the UES corresponds in size and location to that of the cricopharyngeus muscle. Fluoroscopic analysis of sphincter movement indicated that the sphincter high-pressure zone moved 2.0-2.5 cm orally during swallowing and that the magnitude of the orad movement was directly related to the volume of barium swallowed. The maximal anterior-posterior diameter of sphincter opening during a swallow ranged from 0.9 to 1.5 cm and was also directly related to the volume swallowed. The intervals of UES opening and relaxation increased significantly with increasing bolus volume; the duration of UES relaxation ranged from a mean of 0.37 s for dry swallows to 0.65 s for 20-ml swallows. Thus, the dynamics of UES function during deglutition are dependent upon the volume of the swallowed bolus. Larger bolus volumes are accommodated by both an increased diameter of sphincter opening and by prolongation of the interval of sphincter relaxation. Analysis of the timing of other reference points within the pharyngeal swallow sequence indicated that as the manometric interval of UES relaxation increased, the period of laryngeal elevation was prolonged, the UES relaxed earlier and contracted later, and the interval between the onset of laryngeal elevation and hypopharyngeal contraction increased.