吞咽障碍评价标准评定脑卒中后吞咽障碍患者的信度和效度分析

The validity and reliability of Tengdao＇s swallowing evaluation for stroke patients with dysphagia

目的 探讨吞咽障碍评价标准评定脑卒中后吞咽障碍患者吞咽功能的信度和效度。方法采用洼田饮水试验筛查出128名脑卒中后吞咽障碍患者，并根据吞口因障碍严重程度分为轻、中、重度，利用吞咽障碍评价标准和视频吞咽造影检查（VFSS）同时对其吞咽功能进行评价，后者作为效度标准。采用Spearman相关分析进行信度和效标效度评价。结果吞咽障碍评价标准评分与VFSS结果具有显著相关性（r=0．84，P〈0．01）；吞咽障碍评价标准在同一评定者及不同评定者间均有良好的信度；可对吞咽障碍的患者是否发生误吸和住院期间是否发生肺炎进行预测。结论吞咽障碍评价标准适用于脑卒中患者的吞咽功能评价，是一种简单、方便、安全、有效的评估工具。

Objective To study the validity and reliability of Tengdao＇s swallowing standard for stroke patients with dysphagia. Methods A total of 128 patients with poststroke dysphagia took the swallowing test and then were divided into three sub-groups. Their scores on Tengdao＇s evaluation and their fluoroscopy results were analyzed using Spearman＇s correlation coefficient. Intra-elass coefficients （ICCs） were used to examine the intra-rater and inter-rater reliability of Tengdao＇s evaluation. Results Tengdao＇s evaluation possessed good validity and reliability. There was a high correlation between the scores in Tengdao＇s evaluation and fluoroscopy results. Conclusions Tengdao＇s evaluation is valid, reliable, simple and safe. It can be used in the clinic to evaluate the stroke patients with dysphagia.