比较视频透视和内窥镜检查评估新生儿重症监护病房中瓶喂婴儿的吞咽情况。
Comparing videofluoroscopy and endoscopy to assess swallowing in bottle-fed young infants in the neonatal intensive care unit.
机构信息
Department of Communication Sciences and Oral Health, Texas Woman's University, Denton, TX, USA.
Department of Physical Medicine, Baylor University Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2019 Sep;39(9):1249-1256. doi: 10.1038/s41372-019-0438-2. Epub 2019 Jul 22.
OBJECTIVE
To determine the diagnostic accuracy of videofluoroscopy (VFSS) and endoscopy (FEES) in detecting laryngeal penetration and tracheal aspiration in bottle-fed young infants in the NICU.
STUDY DESIGN
VFSS and FEES findings of 22 infants were compared to each other and to a composite reference standard in this prospective study. Sensitivity, specificity, positive and negative predictive values were calculated for each assessment.
RESULT
Agreement between VFSS and FEES was high (92%) for aspiration and moderate (56%) for penetration, with FEES detecting more instances of penetration. Compared to the composite reference standard, FEES had greater sensitivity and a higher negative predictive value for penetration than VFSS. Because of the low prevalence of aspiration, diagnostic accuracy could not be determined for aspiration for either assessment.
CONCLUSION
FEES appears to be more accurate in detecting penetration in this population, and both assessments are valuable tools in a comprehensive feeding and swallowing evaluation.
目的
确定在新生儿重症监护病房（NICU）中，通过视频荧光透视检查（VFSS）和纤维内镜检查（FEES）检测经奶瓶喂养的婴儿发生喉咽渗透和气管吸入的诊断准确性。
研究设计
在这项前瞻性研究中，将 22 例婴儿的 VFSS 和 FEES 检查结果与综合参考标准进行了比较。计算了每种评估的敏感性、特异性、阳性预测值和阴性预测值。
结果
VFSS 和 FEES 对渗透的一致性很高（92%），对穿透的一致性中等（56%），FEES 检测到更多的穿透病例。与综合参考标准相比，FEES 在检测穿透方面的敏感性和阴性预测值均高于 VFSS。由于吸入的患病率较低，因此无法确定这两种评估方法对吸入的诊断准确性。
结论
FEES 似乎在该人群中更准确地检测到穿透，两种评估方法都是全面喂养和吞咽评估的有价值工具。
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