本文選題：洼田飲水試驗 + 吞咽造影��； 參考：《上海交通大學學報(醫(yī)學版)》2016年07期

【摘要】：目的探討洼田飲水試驗對急性腦卒中后吞咽障礙患者誤吸篩查及吞咽障礙診斷的應用價值。方法選取2014年4月—2015年11月在上海市浦東新區(qū)公利醫(yī)院康復醫(yī)學科住院治療的急性腦卒中患者45例,分別進行洼田飲水試驗評估和吞咽造影檢查(VFSS)。評估洼田飲水試驗篩查誤吸和診斷吞咽障礙的可靠性及兩種方法的一致性,同時對比洼田飲水試驗篩查誤吸和診斷吞咽障礙的陽性檢出率。結果以VFSS為"金標準",洼田飲水試驗篩查誤吸的靈敏度為43.75%,特異度為69.23%,陽性預測值為77.78%,陰性預測值為31.03%,洼田飲水試驗和VFSS法一致性檢驗的Kappa值為0.098,兩者不存在一致性(P=0.420);洼田飲水試驗診斷吞咽障礙的靈敏度為97.50%,特異度為20.00%,陽性預測值為90.70%,陰性預測值為50.00%,兩者之間的Kappa值為0.237,不存在一致性(P=0.073);洼田飲水試驗篩查誤吸的陽性檢出率(40.00%)低于診斷吞咽障礙的陽性檢出率(95.56%),差異具有統(tǒng)計學意義(P=0.000)。結論洼田飲水試驗篩查急性腦卒中后吞咽障礙患者誤吸結果可能不可靠,但診斷吞咽障礙結果較可靠。
[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.

【作者單位】： 寧夏醫(yī)科大學臨床醫(yī)學院;上海市浦東新區(qū)公利醫(yī)院康復醫(yī)學科;
【分類號】：R743.3

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