超声观察胎儿食管结构和运动模式的研究  

Sonographic Observation of Normal Anatomy and Physiological Activity of the Fetal Esophagus

作　　者：刘雨函[1] 韩冰[1] 蔡爱露[1] 姜红霞[2] 杨泽宇[1] 王晓光[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳市110004 [2]四平市中心医院超声科

出　　处：《中国超声医学杂志》2011年第8期739-742,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家科技支撑计划资助(No.2006BAI05A04)

摘　　要：目的研究胎儿食管局部解剖(局限于超声切面)和胎儿吞咽的生理特征。方法前瞻性对115例19～39孕周正常胎儿进行5min的食管解剖学超声扫查,首先显示未充盈的食管,然后记录管腔的开放和关闭。结果 115例胎儿中,94例(81.7%)超声能够显示颈、胸、腹3段食管声像图,104例(90.4%)至少显示1段以上食管影像。食管表现2种运动模式:51例(65.4%)食管同时整体短暂开放;27例(34.6%)食管呈蠕动波样从咽部经过纵隔进入胃节段性开放。食管开放时间均值96.1s(10～300s)。结论使用高分辨率超声观察胎儿食管解剖和生理活动是可行的,最常见的胎儿食管运动模式是从咽部到下端的食管腔同时开放,观察胎儿正常食管对产前诊断食管闭锁有所帮助。Objective To focus on the esophageal topographic anatomy（which was limited to ultrasonographic view sections） and physiology of fetal swallowing. Methods In a prospective study,115 consecutive fetal esophagi between 19 and 39 weeks＇gestation were examined by a 5-min normal anatomy scan, and followed by demonstration of esophageal patency and peristaltic waves. Results Complete anatomical visualization of the esophagus was possible in 94 （81.7%） patients and partial visualization in 104 （90.4%） patients using 2D Ultrasonography. Two different patterns of esophageal motility were observed： a simultaneous and short opening of the whole esophagus was found in 51 （65.4%） fetuses;a segmental, peristalsislike movement from the pharynx, through the mediastinum, and into the stomach was found in 27 （34. 6 %） fetuses. The mean time for esophageal patency was 96.1 s （range, 10-300）. Conclusions Demonstration of normal anatomy and physiological activity of fetal esophagus is feasible using appropriate transducers. The most commonly pattern of esophageal motility is the simultaneous relaxation of the upper and lower esophageal sphincters with concurrent opening of the esophageal lumen from the upper thorax to the stomach. Demonstration of a patent esophagus may be helpful in fetuses with suspected esophageal atresia.

关 键 词：超声检查 产前 食管闭锁 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]