Esophageal dysfunction in esophagopharyngeal regurgitation.
Esophageal dysfunction in esophagopharyngeal regurgitation.
复制标题
食管咽反流中的食管功能障碍。
DOI：
10.1016/0016-5085(80)90768-4
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发表时间：
1980
期刊：
影响因子：
29.4
通讯作者：
T. Shuck
中科院分区：
文献类型：
--
作者：
D. Gerhardt;Donald O. Castell;Daniel Winship;T. Shuck
对20例食管咽部反流患者、20例无反流的重度慢性烧心患者和20例正常人进行了食道测压。该手术的目的是确定这些组之间在上食道括约肌和下食道括约肌静息压力以及食道远端蠕动收缩幅度方面的可能差异。正常人和慢性烧灼组的平均上括约肌峰值压显著高于食管咽部反流组(分别为101和108对54毫米汞柱)。正常人下食道括约肌平均静息压(19 Mm Hg)显著高于烧心组(14 Mm Hg)和食管咽部反流组(10 Mm Hg)。反流组的蠕动幅度明显低于正常组和慢性烧灼组。食管内注入0.9%氯化钠和0.1N盐酸后，9名正常受试者上括约肌静息压显著升高，但食管咽部反流组无明显变化。食管咽部反流患者表现为下食道括约肌低血压，蠕动幅度降低，上食道括约肌低血压，上食道括约肌对食管内液体的反应性减弱。我们得出的结论是，在这些患者中，有几种正常的食道机制崩溃，这些机制通常是食管咽反流的屏障。
Esophageal manometry was performed in 20 patients with esophagopharyngeal regurgitation, in 20 patients with severe chronic heartburn but without regurgitation, and in 20 normal subjects. The purpose of the procedure was to identify possible differences between these groups in upper esophageal sphincter and lower esophageal sphincter resting pressures, and in amplitude of peristaltic contraction in the distal esophagus. The mean peak upper esophageal sphincter pressures in normal subjects and in patients with chronic heartburn were significantly greater than in the patients with esophagopharyngeal regurgitation (101 and 108 vs. 54 mmHg, respectively). In the normal subjects, the mean lower esophageal sphincter resting pressure (19 mmHg) was significantly greater than for the heartburn group (14 mmHg) and for the patients with esophagopharyngeal regurgitation (10 mmHg). The amplitude of peristalsis was significantly lower in the group with regurgitation than in both normal subjects and the group with chronic heartburn. Nine normal subjects responded to intraesophageal infusion of 0.9% NaCl and 0.1 N HCl with a significant increase in upper esophageal sphincter resting pressure, but the group with esophagopharyngeal regurgitation showed no significant change. Patients with esophagopharyngeal regurgitation have lower esophageal sphincter hypotension, diminished peristaltic amplitude, upper esophageal sphincter hypotension, and diminished upper esophageal sphincter response to intraesophageal fluid. We conclude there is in these patients a breakdown of several normal esophageal mechanisms which ordinarily serve as barriers to esophagopharyngeal regurgitation.