Department of Otolaryngology, Eye and Ear Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Dysphagia. 2012 Dec;27(4):452-9. doi: 10.1007/s00455-011-9389-2. Epub 2012 Jan 24.
The purpose of this experiment was to confirm the presence of positive subglottic air pressure during swallowing, known as deglutitive subglottic air pressure (DPsub), in a group of healthy individuals. We also sought to determine if respiratory system recoil is responsible for generating the pressure. Ten healthy volunteers underwent direct DPsub measurement via percutaneous puncture of the cricothyroid membrane. Simultaneous DPsub and nasal airflow volumes were recorded while participants swallowed calibrated boluses over a wide range of lung volumes. Body plethysmography was used to determine functional residual capacity and residual volume. A custom respiratory recoil measurement system was used to measure recoil pressures. Regression analysis of lung volume on DPsub and lung volume on recoil pressure yielded strong linear relationships (P < 0.0001, R (2) = 0.71 and P < 0.0001, R (2) = 0.69, respectively). A mixed-model analysis of the effect of method (direct puncture or recoil) on pressure showed that there was no effect (F = 0.63; P = 0.43). By confirming the presence of DPsub in healthy adults and showing that respiratory system recoil is the most likely mechanism that generates DPsub, treatment of persons with dysphagia has even greater potential to be expanded to include consideration of factors that affect respiratory control and recoil forces.
本实验旨在确认健康个体吞咽时会产生正声门下压力，即吞咽时声门下压力（DPsub），并确定呼吸系统回弹是否是产生压力的原因。10 名健康志愿者通过经皮穿刺环甲膜进行直接 DPsub 测量。在参与者在广泛的肺容量范围内吞咽校准的团块时，同时记录 DPsub 和鼻气流体积。体描法用于确定功能残气量和残气量。使用定制的呼吸回弹测量系统测量回弹压力。对肺容量与 DPsub 以及肺容量与回弹压力的回归分析得出了很强的线性关系（P<0.0001，R²=0.71 和 P<0.0001，R²=0.69）。对压力的方法（直接穿刺或回弹）效应的混合模型分析表明，两者之间没有影响（F=0.63；P=0.43）。通过确认 DPsub 在健康成年人中的存在，并表明呼吸系统回弹是产生 DPsub 的最可能机制，治疗吞咽困难的方法甚至更有潜力扩展到包括考虑影响呼吸控制和回弹力量的因素。
