吞咽造影检查联合内镜吞咽检查在脑卒中后吞咽功能评估中的应用价值

Value of angiography combined with endoscopic swallowing test in the evaluation of swallowing function after stroke

目的 探讨电视X线透视吞咽功能检查（VFSS）联合内镜吞咽检查（FEES）在脑卒中患者吞咽功能评估中的应用价值.方法 2014年6月—2016年10月,将收治的108例脑卒中患者随机分为实验组和对照组各54例.对照组采用VFSS进行评估,实验组采用VFSS和FEES进行评估.所有患者根据评估结果进行针对性治疗和康复训练.观察比较两组患者的误吸检出率、治疗前后吞咽功能变化和疗效差异.结果 与对照组（22.22％）相比,实验组患者的误吸检出率（50.00％）明显较高,且差异有统计学意义（χ^2=15.62,P〈0.01）;治疗后,两组患者VFSS评分均较治疗前明显升高（P〈0.05）,且实验组高于对照组,差异有统计学意义（P〈0.01）;实验组总有效率（87.03％）高于对照组（70.37％）,差异有统计学意义（χ^2=3.31,P=0.042）.结论 VFSS联合FEES有助于脑卒中后吞咽功能评估,值得在临床上推广.

Objective -To investigate the value of using video fluoroscopic swallowing study （VFSS） and fiberoptic endoscopic evaluation of swallowing （FEES） in the assessment of swallowing function in patients with stroke. Methods From June 2014 to October 2016, a total of 108 stroke patients were randomly divided into experimental group and control group with 54 cases in each. The control group was evaluated with VFSS. The experimental group was evaluated on the basis of the control group with VFSS and FEES. According to the assessment results, all patients received targeted treatment and rehabilitation training. The detection rate of aspiration, the swallowing function before and after treatment and the difference of curative effect of the two groups were compared. Results Compared with the control group （22.22%）, the detection rate of aspiration in experimental group （50.00%） was significantly higher, and the difference was statistically significant （χ^2= 15.62, P 〈 0.01）. After treatment, the VFSS scores in both groups were significantly higher than those before treatment （P 〈 0.05）. The VFSS scores of the experimental group were significantly higher than those of the control group （P 〈 0.01）. The total effective rate of the experimental group （87.03%） was significantly higher than that of the control group （70.37%）, and the difference was statistically significant （χ^2=3.31, P=0.042）. Conclusions VFSS combined with FEES has an extremely important value in the evaluation of swallowing function after stroke, and it is worth to be popularized clinically.