Lyall P, Bao-Quan Q, Beasley S
Department of Paediatric Surgery, Christchurch Hospital, Private Bag 4710, Christchurch, New Zealand.
Pediatr Surg Int. 2001 Mar;17(2-3):193-5. doi: 10.1007/s003830000457.
The indications for postoperative ventilation and paralysis with neck flexion after repair of oesophageal atresia (OA) have been controversial, mainly because of a paucity of information on oesophageal compliance and the influence of posture on anastomotic tension. This study using a pig model demonstrates that 78.8% of oesophageal lengthening occurs between full flexion and the neutral position, contributing to an increase in oesophageal length of about 9%. Compliance of the oesophagus is a linear function of the natural log of the tension applied. These data imply that any postural change (e.g., head and neck flexion) that allows the oesophagus to shorten may produce an exponential reduction in the tension and suggest that the manoeuvre may be appropriate in long-gap OA where there is considerable tension across the oesophageal anastomosis.
食管闭锁（OA）修复术后通气及颈部屈曲致麻痹的指征一直存在争议，主要原因是关于食管顺应性及体位对吻合口张力影响的信息匮乏。这项使用猪模型的研究表明，78.8%的食管延长发生在完全屈曲位与中立位之间，使食管长度增加约9%。食管顺应性是所施加张力自然对数的线性函数。这些数据表明，任何使食管缩短的体位改变（如头颈部屈曲）都可能使张力呈指数下降，并提示该操作可能适用于长节段OA，此类情况下食管吻合口存在相当大的张力。
