Three tests for predicting aspiration without videofluorography
Three tests for predicting aspiration without videofluorography
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DOI：
10.1007/s00455-002-0095-y
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发表时间：
2003-03-01
期刊：
影响因子：
2.6
通讯作者：
Palmer, JB
中科院分区：
文献类型：
--
作者：
Tohara, H;Saitoh, E;Palmer, JB
吞咽电视荧光检查研究 (VFSS) 是识别误吸和其他吞咽异常的权威测试。当 VFSS 不可行时，非视频荧光检查 (non-VFG) 吞咽临床评估至关重要。我们研究了三种非 VFG 测试评估误吸风险的准确性：（1）吞水测试（将 3 毫升水置于舌下，要求患者吞咽）； (2)食物测试(将4克布丁放在舌背上，要求患者吞咽)； （3）X线检查（吞咽液钡前后拍摄咽部静态X线照片）。 63 名吞咽困难患者分别接受了三项非 VFG 测试和一项 VFSS 评估； 29 名患者在 VFSS 上进行了抽吸。所有三项非 VFG 测试的总分对于预测误吸的敏感性为 90%，对于预测误吸的缺失的特异性为 71%。水和食物测试的总分（不含 X 射线）的敏感性为 90%，特异性为 56%。这些非 VFG 测试有局限性，但在 VFSS 不可行时可能有助于评估患者。它们也可用作筛查程序，以确定哪些吞咽困难患者需要 VFSS。
The videofluorographic swallowing study (VFSS) is the definitive test to identify aspiration and other abnormalities of swallowing. When a VFSS is not feasible, nonvideofluorographic (non-VFG) clinical assessment of swallowing is essential. We studied the accuracy of three non-VFG tests for assessing risk of aspiration: (1) the water swallowing test (3 ml of water are placed under the tongue and the patient is asked to swallow); (2) the food test (4 g of pudding are placed on the dorsum of the tongue and the patient asked to swallow); and (3) the X-ray test (static radiographs of the pharynx are taken before and after swallowing liquid barium). Sixty-three individuals with dysphagia were each evaluated with the three non-VFG tests and a VFSS; 29 patients aspirated on the VFSS. The summed scores of all three non-VFG tests had a sensitivity of 90% for predicting aspiration and specificity of 71% for predicting its absence. The summed scores of the water and food tests (without X-ray) had a sensitivity of 90% and specificity of 56%. These non-VFG tests have limitations but may be useful for assessing patients when VFSS is not feasible. They may also be useful as screening procedures to determine which dysphagia patients need a VFSS.