Hinds N P, Wiles C M
Department of Medicine (Neurology), University Hospital of Wales, Cardiff, UK.
QJM. 1998 Dec;91(12):829-35. doi: 10.1093/qjmed/91.12.829.
The best clinical assessment of swallowing following acute stroke, in order to decide whether to refer a patient to a speech and language therapist (SLT), is uncertain. Independently of the managing clinical team, we prospectively investigated 115 patients (51 male) with acute stroke, mean age 75 years (range 24-94) within 72 h of admission, using a questionnaire, structured examination and timed water swallowing test. Outcome variables included referral to and intervention by a speech and language therapist (SLT), dietary modification, respiratory complications and death. Of those patients in whom an SLT recommended intervention, 97% were detected by an abnormal quantitative water swallowing test; specificity was 69%. An SLT was very unlikely to recommend any intervention if the test was normal. Inability to perform a water test and/or abnormality of the test was associated with significantly increased relative risks of death, chest infection and dietary modification. A timed water swallowing test can be a useful test of swallowing and may be used to screen patients for referral to a speech and language therapist after acute stroke.
为了决定是否将患者转诊给言语和语言治疗师（SLT），急性中风后吞咽功能的最佳临床评估尚无定论。我们独立于管理临床团队，对115例急性中风患者（51例男性）进行了前瞻性研究，这些患者在入院72小时内，平均年龄75岁（范围24 - 94岁），采用问卷调查、结构化检查和定时饮水吞咽测试。结果变量包括转诊给言语和语言治疗师（SLT）并接受其干预、饮食调整、呼吸并发症和死亡。在那些SLT建议进行干预的患者中，97%通过异常的定量饮水吞咽测试被检测出来；特异性为69%。如果测试正常，SLT极不可能建议进行任何干预。无法进行饮水测试和/或测试异常与死亡、胸部感染和饮食调整的相对风险显著增加相关。定时饮水吞咽测试可能是一种有用的吞咽测试，可用于筛选急性中风后转诊给言语和语言治疗师的患者。
