软式喉内窥镜吞咽功能检查在急性脑卒中后患者的应用价值  

Application value of flexible endoscopic examination of swallowing in acute stroke patients with dysphagia

作　　者：张欣然 李永 邹飒枫 王笑丰 刘得龙 Zhang Xinran;Li Yong;Zou Safeng;Wang Xiaofeng;Liu Delong(Department of Otolaryngology Head and Neck Surgery,Dalian Municipal Central Hospital Affiliated of Dalian Medical University,Liaoning Dalian 116033,China)

机构地区：[1]大连医科大学附属大连市中心医院耳鼻喉头颈外科,116033 [2]大连医科大学附属大连市中心医院康复科,116033

出　　处：《中国医师进修杂志》2021年第8期715-718,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的:探讨软式喉内窥镜吞咽功能检查(FEES)对急性脑卒中后吞咽障碍患者误吸筛查、吞咽障碍诊断及评估治疗效果的价值。方法:对2015年10月至2020年1月大连医科大学附属大连市中心医院住院治疗的373例脑卒中后患者进行FEES,分析特征性表现,其中11例行吞咽造影检查(VFSS),并将二者结果进行对比分析,评估FEES对筛查误吸和诊断吞咽障碍的可靠性及两种检查方法的一致性。治疗前后对比FEES结果,评估康复效果。结果:373例患者,洼田饮水试验可疑误吸190例(50.94%),FEES发现误吸268例,误吸检出率为71.85%,其中隐性误吸101例,FEES误吸检出率较洼田饮水试验检出率高。对于可疑环咽肌功能障碍者行VFSS,与FEES结果基本一致。FEES可提供更多的阳性指标,指导临床康复方案,客观判断康复治疗的疗效。结论:吞咽障碍疾病有特征性的咽喉部表现,FEES操作简便,在吞咽障碍疾病的诊断、治疗中有较高的应用价值。Objective To study the application value of flexible endoscopic examination of swallowing(FEES)for the aspiration screening,the diagnosis of dysphagia and evaluation of the therapeutic effectin acute stroke patients with dysphagia.Methods Three hundred and seventy-three patients with acute stroke who hospitalized from October 2015 to January 2020 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University and underwent FEES for analyzing the characteristic performance were enrolled,and 11 cases of them were examined by video fluoroscopic swallowing study(VFSS).The results of the reliability of diagnosis dysphagia of the two methods were compared.The results of FEES for assessing the recovery effect after treatment were evaluated.Results In 373 patients,the FEES revealed 268 cases(71.85%)of aspiration(99 cases)were recessive aspiration,which was better than that in water swallow test(50.94%,190/373).Patients with potential cricopharyngeus achalasia got the same results through both of VFSS and FEES.FEES could provide more positive indicators and guide clinical rehabilitation treatment and objective assessment of rehabilitation effectiveness.Conclusions Acute stroke patients with dysphagia have characteristic laryngeal performance.FEES is simple to operate and has high application value.

关 键 词：脑卒中 吞咽障碍 软式喉内窥镜 吞咽功能检查 

分 类 号：R743.3[医药卫生—神经病学与精神病学]