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UPPER ESOPHAGEAL SPHINCTER AND RECURRENT LARYNGEALPALSY AFTER ESOPHAGECTOMYFORTHORACIC ESOPHAGEAL CANCER

食管上括约肌和食管胸段食管癌术后复发性喉麻痹

基本信息

批准号：
06671300
负责人：
HIGASHINO Masayuki
金额：
$ 0.38万
依托单位：
OSAKA CITY UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

The upper esophageal sphincter prevents reflux into the pharynx. If it function improperly, aspiration pneumonia can result. We studied the functioning of the sphincter in unaanesthetized dogs after denervation under anesthesia of the recurrent laryngeal nerves. the pressure of the sphincter at rest was measured by manometry with a transduoer that measured pressurre around the tip of a catheter. Then the pressurre in response to inflation of a balloon to the diameter of 1.5,2.0 and 2.5cm and at 5 and 10cm aboral to the sphincter was measured. Next, the pressure during perfusion of 0.1 NHCl or NaOH 10cm aboral to the sphincter was measured. These studies were done first in 10 dogs that had undergone only gastrostomy for measurements (controls). Measurements were repeated after the left recurrent laryngeal nerve in the control was cut (L group), after the right recurrent laryngeal nerve in the L group was cut (B group), and after transsection of the esophagus 7cm aboral to the sphincter in the B group (Tgroup). The differences in the pressure at rest were not significant. In each group, balloon inflation to any diameter tested and at either position made the pressure rise above that at rest. This pressure in the L,B,and T groups, however, was significantly lower than in the controls. When the balloon was inflated to 2.5cm when it was 10cm aboral to the sphincter, the pressure in the T group was significantly lower than in the Bgroup. When HCl or NaOH were perfused, the pressure increased gradually in the controls, but not in the other groups. In conclusion, although recurrent laryngeal nerves did not affect the function of the sphincter at rest, they were the afferent routes of the contration by the sphincter as a reflex following distension or chemical stimulation of the esophagus. The intramural nerve network of the cervical esophagus may be another reflex route of contraction of the upper esophageal sphincter.

上食道括约肌可防止反流进入咽部。如果它的功能不正常，可能会导致吸入性肺炎。我们研究了非麻醉犬在喉返神经麻醉下失神经后括约肌的功能。静息状态下括约肌的压力通过测量导管尖端周围压力的换能器进行测压。然后测量直径为1.5、2.0和2.5 cm的球囊在括约肌上方5 cm和10 cm处充气时的压力。然后，测量0.1NHCl或NaOH10 cm灌流至括约肌时的压力。这些研究首先在10只只接受胃造口术的狗身上进行(对照)。对照组切断左侧喉返神经(L组)，L组切断右侧喉返神经(B组)，B组切断距括约肌7 cm处的食道(T组)。安静时的压力差异不显著。在每组受试者中，气囊充气到任何直径，在任何一个位置都会使压力上升到静止状态以上。然而，L组、B组和T组的这种压力明显低于对照组。当球囊在距括约肌10 cm处充气至2.5 cm时，T组压力明显低于B组。当灌流盐酸或氢氧化钠时，对照组的血压逐渐升高，而其他组则无明显变化。总之，虽然喉返神经不影响静息状态下括约肌的功能，但它们是食道扩张或化学刺激后作为反射的括约肌收缩的传入通路。颈段食管壁内神经网络可能是上食道括约肌收缩的另一条反射途径。