Zhang Jianli, Chen Weixiong, Li Jingjia, Chen Ruikai, Kuang Debin, Yang Guanying, Feng Hongmei
Department of Otorhinolaryngology Head and Neck Surgery，the First People's Hospital of Foshan，Foshan，528000，China.
Department of Radiology，the First People's Hospital of Foshan.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Feb;34(2):158-161. doi: 10.13201/j.issn.1001-1781.2020.02.014.
The aim of this study is to investigate the effect of fibreoptic endoscopic of sallowing （FEES） in the assessment of pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma. Fifty-three NPC patients with post-irradiated underwent FEES and video fluoroscopy（VF）.The results were analyzed using the Bolus Residue Scale and Rosenbek's penetration aspiration scale. The agreement in the detection of penetration and aspiration between FEES and VF of liquid（κ=0.56, 95% 0.38-0.73） and porridge（κ=0.64, 95% 0.43-0.81） was "fair". The detection rates of penetration on FEES with liquid and porridge were 60% and 51%, the detection rates of aspiration on VF with liquid and porridge were 70% and 53%. There were no statistical differences. The agreement in the detection of pharyngeal residue between FEES and VF of liquid （κ=0.38, 95%0.12-0.62） and porridge （κ=0.66, 95% 0.44-0.86） was "fair". The detection rates of pharyngeal residue on FEES and VF with porridge were 43% and 45%, the difference was not statistically significant. The detection rates of pharyngeal residue on FEES and VF with liquid were 44% and 24%, and the difference was statistically significant. FEES is an effective and valuable tool for evaluating pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma.
本研究旨在探讨纤维光学吞咽内镜检查（FEES）在评估鼻咽癌放疗后患者咽吞咽困难中的作用。53例鼻咽癌放疗后患者接受了FEES和视频荧光透视检查（VF）。使用团块残留量表和罗森贝克渗透误吸量表对结果进行分析。FEES与VF在检测液体（κ=0.56，95%可信区间0.38 - 0.73）和粥状物（κ=0.64，95%可信区间0.43 - 0.81）的渗透和误吸方面的一致性为“中等”。FEES检测液体和粥状物时的渗透检出率分别为60%和51%，VF检测液体和粥状物时的误吸检出率分别为70%和53%。差异无统计学意义。FEES与VF在检测液体（κ=0.38，95%可信区间0.12 - 0.62）和粥状物（κ=0.66，95%可信区间0.44 - 0.86）的咽残留方面的一致性为“中等”。FEES和VF检测粥状物时的咽残留检出率分别为43%和45%，差异无统计学意义。FEES和VF检测液体时的咽残留检出率分别为44%和24%，差异有统计学意义。FEES是评估鼻咽癌放疗后患者咽吞咽困难的一种有效且有价值的工具。
