咽动态造影与临床评估对误吸检测的对比分析

发布时间：2018-07-17 22:09

【摘要】：目的：①对比研究咽动态造影与临床评估对误吸检出率的差别，选择更准确的误吸检测方法，预警吸入性肺炎，为诊断、治疗提供依据。②渗透是误吸的前提条件。通过分析渗透在不同年龄组中的发生率，初步探讨渗透与年龄的关系。 方法：①收集2012年4月~2013年3月间就诊于山西医科大学附属第一医院放射科行消化道造影检查，经询问病史，，有吞咽功能异常症状的患者56例。分别行咽动态造影检查和临床评估。咽动态造影检查即使用动态序列对该组患者的吞咽过程进行实时记录，观察到对比剂进入声门以下气道内则记为阳性；临床评估选用吞水试验，即嘱患者一次性喝下30ml水，有呛咳者记为阳性。比较二者之间误吸检出率的差别。②收集同期就诊于山西医科大学附属第一医院放射科行消化道检查，无吞咽障碍症状与体征，无神经系统疾患、口咽部疾患，无手术、放疗史的患者218例。按年龄是否达到60岁分为两组，用咽动态造影记录吞咽过程，观察到对比剂进入声门以上气道者记为渗透阳性，比较两组间渗透检出率的差异。 结果：①咽动态造影检查对误吸的检出率高于临床评估方法，差异有统计学意义（P＜0.05）；②渗透在年龄≥60岁组中的检出率高于年龄＜60岁组，差异有统计学意义（P＜0.01）。 结论：①咽动态造影检查可发现临床评估无法检测出的隐匿性误吸，直观显示误吸发生的时相，对预防吸入性肺炎具有重要价值，对康复治疗具有指导意义，可作为临床检测、筛查、评估的重要手段。②渗透在年龄较高人群中发生率较高，需引起临床重视。
[Abstract]:Objective to compare the difference between dynamic pharyngography and clinical evaluation in the detection rate of aspiration mis-aspiration, to select more accurate methods for detecting aspiration, to warn aspiration pneumonia, and to provide a basis for diagnosis and treatment with osmotic therapy. By analyzing the incidence of osmosis in different age groups, the relationship between osmosis and age was preliminarily discussed. Methods from April 2012 to March 2013, 56 patients with abnormal swallowing function were examined by digestive tract angiography in radiology department of the first affiliated Hospital of Shanxi Medical University. Pharyngeal dynamic contrast examination and clinical evaluation were performed. Dynamic pharyngography was used to record the swallowing process of the patients in real time, and the contrast agent was recorded as positive in the airway below glottis, and the clinical evaluation was performed by swallowing water test, that is to say, the patients were told to drink 30ml water at one time. Those who have coughing are recorded as positive. To compare the difference of the detection rate of aspiration by mistake between the two groups. 2. At the same time, the department of radiology of the first affiliated Hospital of Shanxi Medical University underwent digestive tract examination, no symptoms and signs of dysphagia, no diseases of nervous system, diseases of oropharynx, and no operation. 218 patients with history of radiotherapy. The patients were divided into two groups according to whether they were 60 years old or not. The swallowing process was recorded by dynamic pharyngiography. The osmotic positive rate was observed when the contrast agent entered the airway above glottis, and the difference of osmotic detection rate between the two groups was compared. Results the detectable rate of false aspiration was higher in the dynamic pharyngeal angiography than in the clinical evaluation method (P < 0.05). The positive rate of osmotic osmosis in the age 鈮

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