环咽肌切开术期间上食管括约肌静息压力的套索记录
Sleeve recording of upper esophageal sphincter resting pressures during cricopharyngeal myotomy.
作者信息
Pera M, Yamada A, Hiebert C A, Duranceau A
机构信息
Department of Surgery, Université de Montréal, Hôtel-Dieu de Montréal, Québec, Canada.
出版信息
Ann Surg. 1997 Feb;225(2):229-34. doi: 10.1097/00000658-199702000-00012.
OBJECTIVE
The manometric effects of a 6-cm cricopharyngeal myotomy are recorded while the operation is being performed from cervical esophagus to the cricopharyngeus and then to the hypopharynx.
SUMMARY BACKGROUND DATA
Cricopharyngeal myotomy is used in the treatment of oropharyngeal dysphagia of different causes. The operation decreases the resting pressure in the upper esophageal sphincter (UES). The components responsible for this decrease have not been clarified.
METHODS
Fourteen patients with oropharyngeal dysphagia underwent a sleeve recording of the UES resting pressures under general anesthesia before and after sequential myotomy of the pharyngoesophageal junction. Patients were assessed in the awake state before and after the whole myotomy.
RESULTS
Upper esophageal pressures remain unchanged after division of 2 cm of the cervical esophageal muscle. Section of 2 cm of the cricopharyngeal area results in a significant decrease of the sphincter resting pressure (p < 0.01). The division of 2 cm of hypopharyngeal muscle results in a further significant reduction of the resting pressure (p < 0.005).
CONCLUSIONS
Extension of the cricopharyngeal myotomy over hypopharyngeal musculature produces a more significant decrease of UES resting pressure.
目的
记录在从颈段食管至环咽肌再至下咽进行手术时，6厘米环咽肌切开术的测压效果。
摘要背景资料
环咽肌切开术用于治疗不同病因的口咽性吞咽困难。该手术可降低食管上括约肌（UES）的静息压力。导致这种降低的组成部分尚未明确。
方法
14例口咽性吞咽困难患者在咽食管交界处进行序贯性肌切开术前后，于全身麻醉下接受UES静息压力的袖带记录。在整个肌切开术前后，对患者进行清醒状态评估。
结果
切开2厘米颈段食管肌肉后，食管上段压力保持不变。切开2厘米环咽肌区域会导致括约肌静息压力显著降低（p < 0.01）。切开2厘米下咽肌肉会使静息压力进一步显著降低（p < 0.005）。
结论
环咽肌切开术延伸至下咽肌肉组织会使UES静息压力更显著降低。
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