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[推注量对使用小型高分辨率测压导管评估的咽部吞咽动力学的影响]

[Effect of Bolus Volume on Pharyngeal Swallowing Dynamics Evaluated with Small High-Resolution Manometry Catheters].

作者信息

Jungheim Michael, Kallusky Johanna, Ptok Martin

机构信息

Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover.

出版信息

Laryngorhinootologie. 2017 Feb;96(2):112-117. doi: 10.1055/s-0042-118231. Epub 2017 Feb 1.

DOI:10.1055/s-0042-118231
PMID:28147382
Abstract

The bolus volume has a modulating effect on the swallowing dynamics, but previously reported adaptations of the pharyngeal function have been inconsistent. Therefore, the aim of this study was to comprehensively evaluate changes of pressure and time parameters in the pharynx and upper esophageal sphincter (UES) in relation to the swallowed bolus volume with high-resolution manometry (HRM). To examine the normal swallowing physiology, particularly thin HRM probes were used, which were expected to influence the investigated structures only minimally.10 healthy volunteers accomplished 10 swallows with 2 and 10 ml water respectively in an upright position, while an HRM-examination was performed. Pressure and time parameters of the velopharynx, the tongue base region and the UES were determined and analyzed for statistical differences with respect to the bolus volume.Swallowing larger bolus volumes resulted in both, a longer closure of the velopharynx and in a longer opening of the UES. Volume dependent pressure changes in the pharyngeal swallowing sequence were not detectable.Under the chosen test conditions, bolus volume had an impact on the time parameters of the pharyngeal phase, thus, temporal adaptations of the automated swallowing dynamics were detected. Changes in pharyngeal pressure parameters as shown in other studies cannot be confirmed. They may be due to HRM probes with a larger diameter, which take an effect on the pharyngeal structures themselves. With regard to diagnostic aspects, HRM studies should always be conducted with different bolus volumes in order to investigate the swallowing process completely.

摘要

团注体积对吞咽动力学有调节作用,但先前报道的咽部功能适应性并不一致。因此,本研究的目的是通过高分辨率测压法(HRM)全面评估咽部和食管上括约肌(UES)的压力和时间参数相对于吞咽团注体积的变化。为了研究正常吞咽生理学,特别使用了细的HRM探头,预计其对所研究结构的影响最小。10名健康志愿者在直立位分别用2毫升和10毫升水完成10次吞咽,同时进行HRM检查。测定并分析软腭咽、舌根区域和UES的压力和时间参数,以比较团注体积之间的统计学差异。吞咽较大团注体积会导致软腭咽关闭时间延长和UES开放时间延长。未检测到咽部吞咽序列中与体积相关的压力变化。在所选测试条件下,团注体积对咽期时间参数有影响,因此,检测到自动吞咽动力学的时间适应性。其他研究中所示的咽部压力参数变化无法得到证实。这可能是由于直径较大的HRM探头对咽部结构本身产生了影响。在诊断方面,HRM研究应始终使用不同的团注体积进行,以便全面研究吞咽过程。

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