Goldschmid S, Boyce H W, Brown J I, Brady P G, Nord H J, Lyman G H
Department of Medicine, University of South Florida, College of Medicine, Tampa.
Am J Gastroenterol. 1989 Oct;84(10):1255-8.
This study was performed to develop a system to measure dysphagia in an objective fashion, test its correlation with subjective estimates of dysphagia, and encourage the use of a standardized measure of esophageal stenosis. Thirty-five patients with mechanical dysphagia underwent subjective estimates of dysphagia using a dysphagia scale graded from 0 to 5, as well as a diet scale. Lumen diameter was measured endoscopically, using the open or closed biopsy forceps as a measuring guide. Patients were then given barium capsules or tablets of increasing diameter under fluoroscopy, in the upright position. Pills were given sequentially until a pill failed to traverse the esophagus in less than 20 s. The diameter of the pill failing to traverse the esophagus within 20 s correlated strongly with the endoscopically measured diameter by Spearmans rank correlation (Rs = 0.85). The weakest correlation was between endoscopically measured diameter and the dysphagia scale (Rs = 0.48). The diameter of the pill failing to traverse the esophagus within 20 s is an excellent estimate of esophageal lumen diameter. Pill size correlates much better with esophageal lumen diameter than dysphagia or diet scales. This new dysphagia assessment system should simplify standardization of the grading of dysphagia.
本研究旨在开发一种以客观方式测量吞咽困难的系统，测试其与吞咽困难主观评估的相关性，并鼓励使用标准化的食管狭窄测量方法。35例机械性吞咽困难患者使用从0到5分级的吞咽困难量表以及饮食量表对吞咽困难进行主观评估。在内镜检查时，使用开放或闭合活检钳作为测量导向来测量管腔直径。然后让患者在透视下、直立位服用直径逐渐增大的钡剂胶囊或片剂。依次给予药丸，直到一粒药丸在20秒内无法通过食管。在20秒内无法通过食管的药丸直径与内镜测量直径通过斯皮尔曼等级相关性分析显示出强烈相关性（Rs = 0.85）。最弱的相关性是在内镜测量直径与吞咽困难量表之间（Rs = 0.48）。在20秒内无法通过食管的药丸直径是食管管腔直径的良好估计。药丸大小与食管管腔直径的相关性比吞咽困难或饮食量表要好得多。这种新的吞咽困难评估系统应能简化吞咽困难分级的标准化。
