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目的探讨食管内外存在压力差及其与食管癌术后颈部吻合口瘘形成关系。方法应用压力换能器分别检测12只新西兰大白兔的胸腔内压力、胸段食管内压力、颈段食管内压力、食管上括约肌区在静息及咳嗽过程压力的变化,MD3000系统记录并读取压力值。结果咳嗽时胸段食管内压力[P_1=(10.2±0.6)cm H_2O]小于胸内压[P_2=(36.7±1.0)cm H_2O],咳嗽时颈段食管内压力[P_3=(7.5±0.2)cm H_2O)]小于食管上括约肌压力[P_4=(12.0±0.4)cm H_2O]和小于胸段食管内压力[P_1=(10.2±0.6)cm H_2O]。结论颈部吻合口瘘的形成是多方面因素影响的结果,颈部吻合口周围存在的持续性由内向外的压力差是颈部吻合口瘘产生的主要原因之一。
Objective To investigate the existence of pressure difference between the inside and outside of the esophagus and its relationship with the formation of anastomotic fistula after esophagectomy. Methods The pressure changes of thoracic pressure, thoracic esophageal pressure, cervical esophageal pressure, esophageal sphincter area during resting and coughing in 12 New Zealand white rabbits were detected by pressure transducer. The MD3000 system recorded and read Pressure value. Results The intrathoracic esophageal pressure (P 1 = (10.2 ± 0.6) cm H 2 O] was lower than the intrathoracic pressure [P 2 = (36.7 ± 1.0) cm H 2 O] when coughing, and the cervical esophageal pressure during coughing [P 3 = (7.5 ± 0.2) cm H_2O)] was less than the upper esophageal sphincter pressure (P_4 = (12.0 ± 0.4) cm H_2O] and less than the thoracic esophageal pressure (P_1 = (10.2 ± 0.6) cm H_2O]. Conclusions The formation of anastomotic fistula is a result of many factors. The persistent pressure difference from the inside to the outside of the anastomotic neck is one of the main causes of anastomotic fistula.