Study of Swallowing Pressure for Diagnostic Purposes

本研究的目的是设计吞咽压力测量的标准化，并阐明该方法对吞咽困难的诊断价值。用微针尖压力传感器测量吞咽压力，并通过a /D转换器记录舌骨上肌的肌电图，将其数字化并送入软盘。存储在光盘中的数据通过个人计算机在CRO上复制，并使用自制程序计算各种参数。观察吞咽压力曲线、吞咽压力传导速度和食道上高压区松弛时间的正常范围。吞咽压力曲线由咽腔和食管腔的压力峰连接而成。轻度吞咽困难患者的吞咽压力升高，而中度或重度吞咽困难患者的吞咽压力则降低。为了可视化吞咽压力传导的正常或异常模式，提出了吞咽压力传导曲线。在这条曲线中，横坐标表示吞咽压力峰值的时间，纵坐标表示离咽孔的距离。正常受试者的曲线呈s形，这是由于在腭咽部传导速度相对较慢，在中咽部和下咽部传导速度较快，在食道口传导速度较慢。当传导曲线偏离正常模式时，提示中枢吞咽系统功能紊乱。吞咽过程中超高频腔内压力维持在大气压水平的时间超过500毫秒。当持续时间小于500毫秒时，提示食道口不完全松弛。综上所述，吞咽压力的测量可以对吞咽功能进行定量和定性的评价，并且通过对上述三个参数的分析，可以选择可行的治疗方法。少

The purposes of the present study are to devise the standardization of measuring the swallowing pressure and to clarify the diagnostic values of this method in case of dysphagia. The swallowing pressure measured using a micro-tip pressure transducer and the elctromyograms recorded from the suprahyoidal muscles were digitalized through an A/D converter and were fed into floppy discs. The data stored in the discs were reproduced on a CRO through a personal computer and various parameters were calculated using a self-made program. The normal ranges of the following three parameters were investigated: the swallowing pressure curve, the conduction velocity of swallowing pressure and the duration of relaxation of the upper high pressure zone of the esophagus (UHPZ). The swallowing pressure curve was obtained by connecting the peaks of the pressure in the pharyngeal and esophageal cavities. The patients with a slight degree of dysphagia showed the increase of the swallowing pressure and, on t … More he other hand, the patients with a moderate or severe degree of dysphagia showed the decrease of the pressure. To visualize normal or abnormal patterns of conduction of the swallowing pressure, the conduction curve of the swallowing pressure was proposed. In this curve, the abscissa expressed the timing of the peak of the swallowing pressure and the ordinate the distance from the naris. The curve was an S-like figure in normal subjects, since the conduction velocity was relatively slow at the velopharyngeal part, rapid at the meso- and hypo-pharyngies and slow at the esophageal orifice. When the conduction curve was deviated from the normal pattern, a disorder of the central deglutitatory system was suggested. The intraluminal pressure at UHPZ in deglutition remained at the level of atmospheric pressure for longer than 500 msec. When this duration was shorter than 500 msec, an incomplete relaxation of the esophageal orifice was suggested. In conclusion, the measurement of the swallowing pressure could offer quantitative and qualitative evaluations of swallowing function and, in addition, the choice of treatment method was feasible by analyzing the above three parameters. Less