卒中患者床旁吞咽评估研究  

Bedside Assessment of Swallow in Stroke

作　　者：袁强[1] 周红雨[1] 

机构地区：[1]四川大学华西医院神经内科,四川成都610041

出　　处：《华西医学》2009年第1期35-37,共3页West China Medical Journal

基　　金：国家自然科学基金资助项目(30200085)

摘　　要：目的：探索可靠的卒中患者床旁吞咽评估方法。方法：61例住院卒中患者均进行各种床旁吞咽评估筛查及电视透视检查，以后者为金标准探讨各方法的敏感度、特异度及阳性、阴性预测值。结果：六种独立床旁吞咽评估方法与金标准相比较的敏感度在60％～87％之间，特异度在76％～89Yo之间，阳性预测值在50％～69％之间，阴性预测值在86％～95％之间；几种评估方法作为平行试验联合应用时的敏感度在89％～98％之间，阴性预测值在94％～99％之间；几种方法作为序列试验应用时的特异度在97％～99％之间，阳性预测值在82％～90％之间。结论：根据不同方法的预测特点，可得到针对不同患者的、有效的床旁评估方法。床旁吞咽评估简单、有效、便捷，是临床工作中适宜的评估方法。Objective：To search for the best method of bedside assessment of swallow in stroke patients. Methods： Sixty one in-patients after acute stroke were examined with different methods of bedside assessment of swallow and videofluorography. The sensitivities,specificities,positive predictive values and negative predictive values of different as- sessments were investigated based on the videofluorography which was considered as a gold standard. Results：Compared with the videofluorography, sensitivities of the six separate bedside assessments of swallow ranged between 60% and 87 %, specificities between 76 % and 89 %, positive predictive values between 500% and 69 % and negative predictive val- ues between 86% and 95%;several bedside assessments of swallow combined as parallel tests raised sensitivities to between 89% and 98% and negative predictive values to between 86 % and 95 %;several assessments combined as serioal tests raised specificities to between 97 % and 99 % and positive predictive values to between 82 % and 90 %. Conclusion： Based on predictive characterastics of different methods, effective methods of bedside assessment of swallow can be ac- quired for different patients. Therefore bedside assessment of swallow is an important early screening tool for dysphagia and aspiration risk.

关 键 词：卒中 吞咽困难 误吸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]