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于 帆,兰 月,窦祖林,林 拓,卫小梅.空吞咽与食团吞咽对健康人咽期吞咽功能的影响[J].中国康复医学杂志,2014,29(3):218~222
空吞咽与食团吞咽对健康人咽期吞咽功能的影响    点此下载全文
于 帆  兰 月  窦祖林  林 拓  卫小梅
中山大学附属第三医院康复医学科,广州,510630
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摘要:
      摘要 目的:探讨通过使用高分辨率咽腔测压,分析空吞咽与不同黏度食团吞咽对健康人咽部和上食管括约肌功能的影响。 方法:使用高分辨率测压系统,分别测量34例健康志愿者[平均(24.29±5.926)岁]在空吞咽与进食三种不同黏度(5ml水,5ml浓流质,5ml糊状物)的食团情况下,咽部收缩压力峰值,咽部收缩持续时间,咽部压力上升速率,上食管括约肌(UES)松弛残余压,UES松弛持续时间,UES开放前峰值以及UES开放后峰值。使用重复测量的方差分析研究空吞咽与食团吞咽对这些参数的影响。 结果:食团吞咽与空吞咽时,咽部收缩压力峰值差异无显著性意义。而空吞咽时,UES松弛残余压、开放前压力峰值、咽部收缩持续时间和咽部压力上升速率明显高于食团吞咽,而UES松弛持续时间与UES开放后峰值明显低于食团吞咽。而不同黏度的食团吞咽之间的参数差异无显著性意义。 结论:不同的吞咽类型会影响健康人咽部与UES的压力和持续时间。明确空吞咽与不同黏度食团吞咽健康人的咽期吞咽生理学变化,为进一步探究吞咽障碍的生理与病理提供了研究基础。
关键词:空吞咽  食团黏度  高分辨率咽腔测压  咽期吞咽生理
Effects of bolus and dry swallowing on swallowing function in healthy volunteers using high-resolution manometry    Download Fulltext
The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630
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Abstract:
      Abstract Objective: To evaluate the effects of dry swallow and different consistencies bolus swallows on physiologic pressure and duration in healthy adults with using high-resolution manometers. Method: Thirty-four young healthy adults [mean (24.29±5.926)years] participated in this study. Upper esophageal sphincter(UES) and pharyngeal manometric pressures were measured during orderly dry swallow and different consistencies (water, thick liquid and plaster materials in 5ml volume) bolus swallow. Variables included maximum pharyngeal pressure, duration of pharyngeal pressure above baseline and rate of pressure increase of pharyngeal and minimum pressure of UES relaxation, duration of UES relaxation, maximum preopening UES pressure and maximum post-closure UES pressure were analyzed. Result: There was no significant difference of maximum pharyngeal pressure during dry swallow and bolus swallow. Significant changes of other parameters were identified. In general, UES minimum pressure, maximum preopening UES pressure, rate of pressure increase of pharyngeal and pharyngeal duration during dry swallow were significantly higher than that during bolus swallows, however, UES relaxation duration, and maximum post-closure UES pressure measures during dry swallow were significant lower than that measurers during bolus swallows. Those parameters were not differed significantly among water, thick liquid and plaster materials. No significant difference of maximum pressure of pharyngeal between different swallow type was identified. Conclusion: Different swallow types demonstrated significant effect on physiologic pressure and duration in healthy adults. Identified difference between dry swallow and different viscosities bolus swallows might help to understand normal and pathological swallowing deeply.
Keywords:dry swallow  bolus consistency  high-resolution manometry  pharyngeal swallowing physiology
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