Study of Swallowing Pressure for Diagnostic Purposes

本研究的目的是设计测量吞咽压力的标准化方法，并阐明该方法在吞咽困难情况下的诊断价值。用微尖压力传感器测得的吞咽压和舌骨上肌记录的肌电通过A/D转换器数字化后送入软盘。储存在光盘中的数据通过个人计算机在CRO上再现，并使用自制的程序计算各种参数。测定吞咽压曲线、吞咽压传导速度和食道上段高压区松弛时间3个参数的正常范围。通过咽腔和食管腔压力峰值的连接得到吞咽压力曲线。轻度吞咽困难患者吞咽压升高，t-…升高。而吞咽困难中、重度患者则表现为压力下降。为了直观显示正常或异常的吞咽压传导模式，提出了吞咽压传导曲线。在这条曲线中，横坐标表示吞咽压力峰值的时间，纵坐标表示距鼻孔的距离。正常人咽闭部传导速度较慢，中咽部传导速度较快，食管口传导速度较慢，呈S样曲线。当传导曲线偏离正常模式时，提示中枢吞咽系统紊乱。吞咽时UHPZ的管腔内压力保持在大气压水平超过500毫秒。当持续时间小于500毫秒时，建议食管口不完全松弛。结论：吞咽压的测定可以为吞咽功能提供定量和定性的评价，另外，通过对上述三个参数的分析，表明治疗方法的选择是可行的。较少

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