[New scoring proposed for endoscopic swallowing evaluation and clinical significance].
[New scoring proposed for endoscopic swallowing evaluation and clinical significance].
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内镜吞咽评估新评分的提出及临床意义
DOI：
10.3950/jibiinkoka.113.670
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
K. Hirose
中科院分区：
文献类型：
--
作者：
M. Hyodo;Kaori Nishikubo;K. Hirose
随着人口老龄化，吞咽困难正成为一个严重的医学和社会问题。适当的治疗需要客观地评估吞咽。我们开发的用于灵活的内窥镜吞咽评估（FEES）的简单的、基于临床的评分使用四个参数--（1）谷和梨状窦处的唾液淤积程度，（2）用内窥镜触摸会厌或杓状软骨引起的声门闭合反射，（3）通过“白液”时间评估的吞咽反射启动，和（4）吞咽蓝色水后的咽部清除率-分类为0表示正常，1表示轻度受损，2表示中度，或3表示重度。经验丰富的耳鼻喉科专家在治疗吞咽困难的主题与非专家的耳鼻喉科专家和语音语言听力治疗师的评分显着相关。通过视频荧光造影评估的咽部清除率与FEES清除率评分相关，误吸严重程度与总评分相关，具有统计学显著性。喂养程序相关的四个参数的总分显着，表明其在决定口服食物摄入量的有用性。因此，我们的新评分在评估吞咽困难的严重程度和特征方面简单可靠，并且具有潜在的临床优势。
Dysphagia is becoming a critical medical and social issue with aging population. Appropriate treatment requires that swallowing be assessed objectively. The simple, clinic-based scoring we developed for flexible endoscopic evaluation of swallowing (FEES) uses four parameters--(1) the salivary pooling degree at the vallecula and piriform sinuses, (2) the glottal closure reflex induced by touching the epiglottis or arytenoid with the endoscope, (3) swallowing reflex initiation assessed by "white-out" timing, and (4) pharyngeal clearance after blue-dyed water is swallowed-categorized as 0 for normal, 1 for mildly impaired, 2 for moderate, or 3 for severe. Scores given by experienced otolaryngologists expert in treating dysphagic subjects correlated significantly with those of nonexpert otolaryngologists and speech-language-hearing therapists. Pharyngeal clearance evaluated by videofluorography correlated with FEES clearance scores, as did aspiration severity with total scores statistically significantly. Feeding procedures related significantly to total scores for the four parameters, indicating its usefulness in deciding oral food intake. Our new scoring is thus simple and reliable in evaluating dysphagia severity and features, and potentially clinically advantageous.