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Standardization of quantitative evaluation for swallowing disturbance

吞咽障碍定量评估标准化

基本信息

批准号：
18591870
负责人：
HYODO Masamitsu
金额：
$ 2.33万
依托单位：
Ehime University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

项目摘要

Quantitative standardized evaluation of swallowing function is mandatory for treating patients with dysphagia in consideration of their quality of life. However, there has not been any established evaluation criteria for swallowing disturbance. In this study, we aimed to assess the pathological severity of swallowing function of the dysphagic patients multifacetedly and quantitatively, and establish standardized evaluation criteria.Forty-two patients with dysphagia due to cerebrovascular or neuromuscular diseases (35 males and 12 females, mean age : 68.9 years) were enrolled in this study. Their swallowing functions were examined by videoendoscopy and videofluorography. By videoendoscopic observation, 1) salivary pooling in the vallecula and piriform sinuses, 2) glottal-closure reflex, 3) swallowing reflex, and 4) pharyngeal clearance after swallowing 3ml of blue-dye water were scored into 0-3, respectively. By videofluorographic study, pharyngeal clearance after swallowing 5ml of balium was also scored into 0-3, and aspiration was evaluated.The results of scoring of videoendoscopy varied insignificantly among examiners, demonstrating that videoendoscopy can quantitatively evaluate the severity of dysphagia. Pharyngeal clearance by videoendoscopy correlated with pharyngeal clearance or aspiration by videofluoroscopy. In conclusion, 1) salivary pooling in the vallecula and piriform sinuses, 2) glottal-closure reflex, 3) swallowing reflex, and 4) pharyngeal clearance after swallowing 3ml of blue-dye water are useful tools for evaluating swallowing disturbance. And scoring of these parameters can quantitatively evaluate the severity of dysphagia.

吞咽功能的量化标准化评估对于吞咽困难患者的治疗是强制性的，考虑到他们的生活质量。然而，目前还没有关于吞咽干扰的任何既定评估标准。本研究旨在多方面、定量地评估吞咽障碍患者吞咽功能的病理严重程度，并建立标准化的评估标准。42例脑血管或神经肌肉疾病所致吞咽障碍患者，男35例，女12例，平均年龄68.9岁。通过视频内窥镜和摄像透视检查患者的吞咽功能。电视内窥镜观察：1)腭窝和梨状窦唾液淤积，2)声门闭合反射，3)吞咽反射，4)咽部清晰度分别为0~3分。通过摄像透视检查，吞咽5ml巴比灵后咽部清晰度评分也为0~3分，并对误吸情况进行评分，不同检查者之间的评分差异无统计学意义，说明视频内窥镜检查可以定量评估吞咽困难的严重程度。电视内窥镜的咽部清晰度与电视透视的咽部清理率或吸入率相关。综上所述，1)山谷和梨状窦的唾液积聚，2)声门关闭反射，3)吞咽反射，4)吞咽3ml蓝染料水后的咽部清理是评估吞咽障碍的有用工具。这些参数的评分可以定量评估吞咽困难的严重程度。