标准吞咽功能评估在拔管后误吸筛查中的应用  

APPLICATION OF STANDARDIZED SWALLOWING ASSESSMENT IN SCREENING POST-EXTUBATION ASPIRATION

作　　者：郝桂华[1] 于帮旭[1] 孙运波[1] 代明营[1] 方巍[1] 

机构地区：[1]青岛大学医学院附属医院SICU,山东青岛266003

出　　处：《青岛大学医学院学报》2012年第6期473-475,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨标准吞咽功能评估(SSA)在机械通气病人拔管后误吸筛查中的应用价值。方法对59例机械通气病人进行SSA筛查和电视X线透视吞咽功能检查(VFSS)。以VFSS为金标准,计算SSA对拔管后误吸诊断的灵敏度、特异度、阳性预测值和阴性预测值。比较SSA筛查阳性病人和阴性病人的肺炎发生率。结果SSA对拔管后误吸诊断的灵敏度为86.7%,特异度为65.4%,阳性预测值为74.3%,阴性预测值为80.9%。14例隐匿性误吸病人中有11例SSA筛查为阳性。SSA阳性病人的肺炎发生率高于SSA阴性病人(χ2=3.67,P<0.05)。结论 SSA用于机械通气病人拔管后的误吸筛查具有较高的灵敏度和特异度,并对误吸性肺炎有良好的预测价值。Objective To investigate the value of Standardized Swallowing Assessment（SSA） in screening post-extubation aspiration in mechanical ventilated patients.Methods Fifty-nine patients undergoing mechanical ventilation received SSA screen and video fluoroscopic swallowing studies（VFSS）.The SSA was then measured against the VFSS study for sensitivity,specificity,positive predictive value and negative predictive value for aspiration.The incidence of pneumonia between patients with positive and negative SSA was compared.Results Sensitivity,specificity,positive predictive value and negative predictive value of SSA for aspiration were 86.7%,65.4%,74.3%,and 80.9%,respectively.Of 14 patients with concealed aspiration,11 showed positive on SSA test.The patients with positive SSA had a higher incidence of pneumonia（χ2=3.67,P〈0.05）.Conclusion SSA is a valid and valuable screening tool for aspiration in mechanically ventilated patients.

关 键 词：呼吸 人工 吞咽障碍 标准吞咽功能评估 

分 类 号：R473.74[医药卫生—护理学]