Andreollo N A, Thompson D G, Kendall G P, Earlam R J
Department of Gastroenterology, London Hospital, Whitechapel.
Gut. 1988 Feb;29(2):161-6. doi: 10.1136/gut.29.2.161.
Responses of the cricopharyngeal sphincter to graded intraluminal distension were studied in order to determine its response threshold and to define the functional relationship between the sphincter and oesophageal body. Nine normal subjects underwent manometric study using a multilumen tube with an attached inflatable balloon sited 10 cm below the sphincter. Sphincteric and oesophageal motor responses to six graded balloon inflations were recorded in each subject. The sphincter responded to distension with increasing rise in pressure, from a median value of 42.5 mmHg at lowest levels of distension to 95 mmHg at maximal tolerated distension. Non-swallow related contractile activity was stimulated in the oesophageal body proximal to the distension and increased in quantity as inflation progressed. Distal propagation of this secondary activity was progressively inhibited with increasing distension. These interrelated changes thus show the normal upper oesophageal clearance responses to intraluminal distension. It is suggested that their more widespread application, in addition to standard manometric techniques, might provide a more rational evaluation of those patients suspected to have impaired oesophageal clearance, but in whom standard manometry is non-diagnostic.
为了确定环咽括约肌的反应阈值并明确该括约肌与食管体之间的功能关系，对环咽括约肌对不同程度腔内扩张的反应进行了研究。9名正常受试者使用多腔管进行测压研究，该管在括约肌下方10厘米处附有一个可充气气球。记录了每个受试者对6次不同程度气球充气时括约肌和食管的运动反应。括约肌对扩张的反应是压力逐渐升高，从最低扩张水平时的中位数42.5 mmHg到最大耐受扩张时的95 mmHg。在扩张近端的食管体中，非吞咽相关的收缩活动受到刺激，并且随着充气程度的增加而数量增多。随着扩张程度的增加，这种继发性活动的向远端传播逐渐受到抑制。因此，这些相互关联的变化显示了食管上段对腔内扩张的正常清除反应。有人提出，除了标准测压技术外，更广泛地应用这些方法可能会为那些怀疑食管清除功能受损但标准测压无诊断结果的患者提供更合理的评估。
