Tohara Haruka, Saitoh Eiichi, Mays Keith A, Kuhlemeier Keith, Palmer Jeffrey B
Department of Rehabilitation Medicine, Fujita Health University, Aichi, Japan.
Dysphagia. 2003 Spring;18(2):126-34. doi: 10.1007/s00455-002-0095-y.
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.
电视荧光吞咽造影检查（VFSS）是识别误吸及其他吞咽异常的决定性检查。当无法进行VFSS时，非电视荧光吞咽造影（非VFG）的吞咽临床评估至关重要。我们研究了三种非VFG检查评估误吸风险的准确性：（1）水吞咽试验（将3毫升水置于舌下，要求患者吞咽）；（2）食物试验（将4克布丁置于舌背，要求患者吞咽）；（3）X线检查（吞咽液体钡剂前后拍摄咽部静态X线片）。63名吞咽困难患者分别接受了这三种非VFG检查及一次VFSS检查；29例患者在VFSS检查时有误吸情况。所有三种非VFG检查的总分预测误吸的敏感度为90%，预测无误吸的特异度为71%。水试验和食物试验（不包括X线检查）的总分敏感度为90%，特异度为56%。这些非VFG检查有局限性，但在无法进行VFSS时可能有助于评估患者。它们也可能作为筛查程序，以确定哪些吞咽困难患者需要进行VFSS检查。
