Study of Swallowing Pressure for Diagnostic Purposes

本研究的目的是设计标准化的测量吞咽压力，并阐明这种方法在吞咽困难的诊断价值。通过A/D转换器将使用微尖端压力传感器测量的吞咽压力和从舌骨上肌记录的肌电图数字化，并送入软盘。通过个人计算机在CRO上再现存储在盘中的数据，并使用自制程序计算各种参数。研究了吞咽压力曲线、吞咽压力传导速度和食管上高压区（UHPZ）松弛持续时间三项参数的正常范围。通过连接咽腔和食管腔压力的峰值获得吞咽压力曲线。轻度吞咽困难患者吞咽压力增加， 关于我们 中、重度吞咽困难患者血压下降。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。在该曲线中，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。正常人的传导速度曲线呈S形，表现为咽部传导速度较慢，中咽部和下咽部传导速度较快，食管口部传导速度较慢。当传导曲线偏离正常模式时，提示中枢吞咽系统紊乱。吞咽时UHPZ的管腔内压力保持在大气压水平超过500 msec。当持续时间短于500毫秒时，提示食管口不完全松弛。结论：吞咽压力的测量可以对吞咽功能进行定量和定性的评价，通过对上述三个参数的分析，选择治疗方法是可行的。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