软式喉内窥镜结合染料试验在卒中后隐性误吸中的应用

doi:10.3969/j.issn.1006-9771.2023.02.012

摘要/Abstract

摘要：

目的探讨软式喉内窥镜吞咽功能检查(FEES)结合染料试验对卒中后吞咽障碍患者隐性误吸的诊断价值。方法选取2021年12月至2022年6月在徐州市中心医院康复科住院治疗的脑卒中患者50例，进行FEES和透视荧光吞咽检查(VFSS)。比较两者检查结果。结果 FEES误吸检出率高于VFSS(χ² = 7.000, P < 0.05)。FEES对于进食液体食物时误吸检出率高于VFSS (χ² = 4.000, P < 0.05)；两种方法对于进食糊状(κ = 0.941, P < 0.001)及固体食物(κ = 0.779, P < 0.001)时一致性很好。两种方法食物残留部位一致性较好(κ = 0.818, P < 0.001)；3种食物类型残留部位一致性均很好(κ ≥ 0.862, P < 0.001)。两种方法对于3种食物类型Rosenbek渗漏-误吸量表评分均无显著性差异(Z < 0.667, P > 0.05)。结论 FEES结合染料试验可用于评估卒中后隐性误吸。

关键词: 吞咽障碍, 软式喉内窥镜, 透视荧光吞咽检查, 隐性误吸, 咽收缩运动

Abstract:

Objective To explore the diagnostic value of fiberoptic endoscopic examination of swallowing (FEES) combined with dye test in patients with post-stroke dysphagia and silent aspiration.Methods From December, 2021 to June, 2022, 50 stroke patients in the Rehabilitation Department of Xuzhou Central Hospital were selected. They were assessed with FEES and videofluoroscopic swallowing study (VFSS), and compared. Results The detection rate of aspiration was higher with FEES than with VFSS (χ² = 7.000, P < 0.05), and especially for liquid food (χ² = 4.000, P < 0.05). There was a good consistency when consuming paste food (κ = 0.941, P < 0.001) and solid food (κ = 0.779, P < 0.001). There was a good consistency in the food residue site between two methods (κ = 0.818, P < 0.001), as well as for all the three food types (κ ≥ 0.862, P < 0.001). There was no significant difference in the scores of Penetration Aspiration Scale of three food types between two methods (Z < 0.667, P > 0.05). Conclusion FEES combined with dye test can be used for evaluating silent aspiration after stroke.

Key words: dysphagia, fiberoptic endoscopic examination of swallowing, videofluoroscopic swallowing study, silent aspiration, pharyngeal contractile movement

中图分类号:

R743.3

周慧, 巩尊科, 田耕润, 顾成晨, 王世雁, 王蜜. 软式喉内窥镜结合染料试验在卒中后隐性误吸中的应用[J]. 《中国康复理论与实践》, 2023, 29(2): 231-237.

ZHOU Hui, GONG Zunke, TIAN Gengrun, GU Chengchen, WANG Shiyan, WANG Mi. Application of fiberoptic endoscopic examination of swallowing combined with dye test in silent aspiration after stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(2): 231-237.

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VFSS	FEES
VFSS	会厌谷残留	梨状窝残留	无残留
会厌谷残留	43	4	0
梨状窝残留	5	41	0
无残留	0	0	2