纤维鼻咽喉镜吞咽功能检查对脑卒中后吞咽障碍的诊断价值

Diagnostic value of fiberoptic endoscopic examination of swallowing in dysphagia after stroke

目的评价纤维鼻咽喉镜吞咽功能检查（fiberoptic endoscopic examination of swallowing，FEES）对于脑卒中后吞咽障碍的诊断价值。方法对22例急性脑梗死患者进行吞钡电视透视（videofluoroscopy，VF）检查和FEES。以VF检查为金标准，计算FEES对于急性脑卒中患者误吸、渗漏、穿透和潴留诊断的灵敏度、特异度、阳性预测值和阴性预测值。结果FEES对于穿透诊断的灵敏度为83．3％，特异度为90．0％；对误吸诊断的灵敏度、特异度均为90．9％；对潴留诊断的灵敏度为100％，特异度为77．8％；对渗漏诊断的灵敏度为73．3％，特异度为71．4％。结论FEES对于急性脑卒中患者穿透、误吸和潴留诊断的可靠性较好，是评估脑卒中后吞咽障碍的有力工具。

Objective To evaluate the diagnostic value of fiberoptic endoscopic examination of swallowing （FEES） in dysphagia after stroke. Methods Twenty-two patients with acute ischemie stroke were given both FEES and videofluoroscopy（VF）. The FEES was then measured against the videofluoroscopy study for sensitivity, specificity, positive predictive value and negative predictive value for determining aspiration, spillage, penetration and residue. Results Sensitivity for penetration, aspiration, residue and spillage were 83.3~ , 90. 9%, 100% and 73.3% , respectively. Specificity for these 4 parameters were 90.0% , 90. 9% , 77.8% and 71.4% , respectively. Conclusions FEES may detect penetration, aspiration and residue reliably in acute stroke patients. FEES is a valid and valuable tool for evaluating dysphagia after stroke.