洼田饮水试验在急性脑卒中后吞咽障碍患者中的应用价值

发布时间：2018-05-05 07:05

本文选题：洼田饮水试验 + 吞咽造影　；参考：《上海交通大学学报(医学版)》2016年07期

【摘要】：目的探讨洼田饮水试验对急性脑卒中后吞咽障碍患者误吸筛查及吞咽障碍诊断的应用价值。方法选取2014年4月—2015年11月在上海市浦东新区公利医院康复医学科住院治疗的急性脑卒中患者45例,分别进行洼田饮水试验评估和吞咽造影检查(VFSS)。评估洼田饮水试验筛查误吸和诊断吞咽障碍的可靠性及两种方法的一致性,同时对比洼田饮水试验筛查误吸和诊断吞咽障碍的阳性检出率。结果以VFSS为"金标准",洼田饮水试验筛查误吸的灵敏度为43.75%,特异度为69.23%,阳性预测值为77.78%,阴性预测值为31.03%,洼田饮水试验和VFSS法一致性检验的Kappa值为0.098,两者不存在一致性(P=0.420);洼田饮水试验诊断吞咽障碍的灵敏度为97.50%,特异度为20.00%,阳性预测值为90.70%,阴性预测值为50.00%,两者之间的Kappa值为0.237,不存在一致性(P=0.073);洼田饮水试验筛查误吸的阳性检出率(40.00%)低于诊断吞咽障碍的阳性检出率(95.56%),差异具有统计学意义(P=0.000)。结论洼田饮水试验筛查急性脑卒中后吞咽障碍患者误吸结果可能不可靠,但诊断吞咽障碍结果较可靠。
[Abstract]:Objective to explore the application value of drinking water test in low-lying field for the diagnosis of mistaken aspiration and dysphagia in patients with dysphagia after acute stroke. Methods 45 patients with acute stroke hospitalized in the rehabilitation medicine department of Public Hospital of Shanghai Pudong District from April 2014 to November 2015 were selected and divided into the evaluation of drinking water test and swallowing. VFSS. Evaluate the reliability and consistency of the two methods of mistaken aspiration and diagnosis of dysphagia in potable field drinking test. At the same time, the positive rates of mistaken aspiration and diagnosis of dysphagia were compared. The results showed that VFSS was the "gold standard", and the sensitivity of the mistaken aspiration was 43.75%, the specificity was 69.23%, and the specificity was 69.23%. The predictive value was 77.78% and the negative predictive value was 31.03%. The Kappa value of the conformance test in the potable water test and the VFSS method was 0.098, and there was no consistency (P=0.420). The sensitivity of the water test in the depression was 97.50%, the specificity was 20%, the positive predictive value was 90.70%, the negative predictive value was 50%, and the Kappa value between the two was 0.. 237, there was no consistency (P=0.073); the positive detection rate of mistaken aspiration (40%) was lower than the positive rate of diagnostic swallowing disorder (95.56%), and the difference was statistically significant (P=0.000). Conclusion the results of deglutition screening for patients with dysphagia after acute stroke may be unreliable, but the diagnosis of swallowing disorder results in the diagnosis of swallowing disorder. It is more reliable.

【作者单位】：宁夏医科大学临床医学院;上海市浦东新区公利医院康复医学科;
【分类号】：R743.3

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