目的:探讨纤维内镜评估吞咽功能(fiberoptic endoscopic evaluation of swallowing, FEES)在累及舌根的舌癌(both the oral tongue and the base of the tongue, OBOT)患者中的临床应用。方法:对2022年4月至2023年5月于我院初诊为累及O...目的:探讨纤维内镜评估吞咽功能(fiberoptic endoscopic evaluation of swallowing, FEES)在累及舌根的舌癌(both the oral tongue and the base of the tongue, OBOT)患者中的临床应用。方法:对2022年4月至2023年5月于我院初诊为累及OBOT病变的患者术前、术后1周、1月和1年进行吞咽功能评估。吞咽功能的评估包括MD安德森吞咽困难量表(MD Anderson Dysphagia Inventory, MDADI)、华盛顿大学生活质量问卷(University of Washington Quality-of-Life Questionnaire, UW-QOL)、头颈癌表现状态量表(Performance Status Scale for Head and Neck Cancer, PSS-HN)、洼田饮水试验(water swallow test, WST)、舌运动测量和FEES[包括渗透-吸入量表(Penetration-Aspiration Scale, PAS)和口咽吞咽效率(oropharyngeal swallowing efficiency, OPSE)]。并对FEES的评估OBOT的可靠性进行统计分析。结果:共有21例患者纳入研究。FEES具有较高的诊断价值(ROC曲线下面积=0.916)。FEES结果与WST和MDADI评分显著相关(P<0.001)。术后1年,累及OBOT病变患者的吞咽功能恢复到术前水平,但OPSE明显下降,生活质量仍受影响(P<0.001)。结论:FEES是评估累及OBOT病变患者术后吞咽功能的可靠方法,值得临床推广。在术后随访中,虽然这些患者的吞咽功能可以恢复,但应注意吞咽效率和生活质量。展开更多
Background: Although a variety of technical and clinical problems of capsule endoscopy have been reported, their incidence and clinical importance are unknown. The objective was to evaluate the incidence and the type ...Background: Although a variety of technical and clinical problems of capsule endoscopy have been reported, their incidence and clinical importance are unknown. The objective was to evaluate the incidence and the type of such events. Methods: This was a retrospective analysis of 733 consecutive examinations at 4 large referral centers. The main outcome measurements were that the problems were classified as “technical," i.e., related to the functioning of the equipment, and “clinical," i.e., related to patient characteristics. For each type of event, the causes and the impact on the ability to reach a diagnosis were examined. Results: A total of 183 problems were recorded in 174 patients (23.7%): one problem occurred in 165 patients, two in 9 patients. In 8.46%of patients, technical limitations or failures, or clinical complications prevented or hampered diagnosis. Technical problems (e.g., gaps in the recordings, short duration of capsule batteries, failure of downloading) occurred in the early phase of capsule use in 8.6%of examinations and prevented or hampered diagnosis in 2.9%. Clinical problems (difficulty/inability to swallow the capsule, incomplete small-bowel examination) occurred in 16.4%of examinations and hampered or prevented diagnosis in 6.4%. Capsule retention that required surgical or endoscopic retrieval occurred in 1.9%of cases. Conclusions: Technical problems were rare and hampered or prevented the diagnosis in a very small number of cases. The majority of clinical failures were related to an incomplete small-bowel examination.展开更多
文摘目的:探讨纤维内镜评估吞咽功能(fiberoptic endoscopic evaluation of swallowing, FEES)在累及舌根的舌癌(both the oral tongue and the base of the tongue, OBOT)患者中的临床应用。方法:对2022年4月至2023年5月于我院初诊为累及OBOT病变的患者术前、术后1周、1月和1年进行吞咽功能评估。吞咽功能的评估包括MD安德森吞咽困难量表(MD Anderson Dysphagia Inventory, MDADI)、华盛顿大学生活质量问卷(University of Washington Quality-of-Life Questionnaire, UW-QOL)、头颈癌表现状态量表(Performance Status Scale for Head and Neck Cancer, PSS-HN)、洼田饮水试验(water swallow test, WST)、舌运动测量和FEES[包括渗透-吸入量表(Penetration-Aspiration Scale, PAS)和口咽吞咽效率(oropharyngeal swallowing efficiency, OPSE)]。并对FEES的评估OBOT的可靠性进行统计分析。结果:共有21例患者纳入研究。FEES具有较高的诊断价值(ROC曲线下面积=0.916)。FEES结果与WST和MDADI评分显著相关(P<0.001)。术后1年,累及OBOT病变患者的吞咽功能恢复到术前水平,但OPSE明显下降,生活质量仍受影响(P<0.001)。结论:FEES是评估累及OBOT病变患者术后吞咽功能的可靠方法,值得临床推广。在术后随访中,虽然这些患者的吞咽功能可以恢复,但应注意吞咽效率和生活质量。
文摘Background: Although a variety of technical and clinical problems of capsule endoscopy have been reported, their incidence and clinical importance are unknown. The objective was to evaluate the incidence and the type of such events. Methods: This was a retrospective analysis of 733 consecutive examinations at 4 large referral centers. The main outcome measurements were that the problems were classified as “technical," i.e., related to the functioning of the equipment, and “clinical," i.e., related to patient characteristics. For each type of event, the causes and the impact on the ability to reach a diagnosis were examined. Results: A total of 183 problems were recorded in 174 patients (23.7%): one problem occurred in 165 patients, two in 9 patients. In 8.46%of patients, technical limitations or failures, or clinical complications prevented or hampered diagnosis. Technical problems (e.g., gaps in the recordings, short duration of capsule batteries, failure of downloading) occurred in the early phase of capsule use in 8.6%of examinations and prevented or hampered diagnosis in 2.9%. Clinical problems (difficulty/inability to swallow the capsule, incomplete small-bowel examination) occurred in 16.4%of examinations and hampered or prevented diagnosis in 6.4%. Capsule retention that required surgical or endoscopic retrieval occurred in 1.9%of cases. Conclusions: Technical problems were rare and hampered or prevented the diagnosis in a very small number of cases. The majority of clinical failures were related to an incomplete small-bowel examination.
