Palmer J B, Kuhlemeier K V, Tippett D C, Lynch C
Department of Rehabilitation Medicine, Good Samaritan Hospital, Baltimore, Maryland.
Dysphagia. 1993;8(3):209-14. doi: 10.1007/BF01354540.
This paper presents a detailed protocol for performing the videofluorographic swallowing study (VFSS), and describes how it evolved from its antecedents. The objectives of the VFSS are both diagnostic and therapeutic. Preparing for the VFSS is described, including the equipment, food preparation, and a brief discussion of the clinical evaluation. The detailed description of the VFSS procedure covers the position of the patient, the foods presented, the views obtained, modifications of feeding and swallowing that are commonly employed, the standardized set of observations, and reporting the results. Criteria for deviating from the protocol or aborting the study are presented. The VFSS does not necessarily end when a patient aspirates. Indeed, the complete evaluation of aspiration, and the effects of maneuvers designed to reduce it, is a major purpose of the VFSS. Modifications of feeding and swallowing are tested empirically during the study. The modifications include therapeutic and compensatory techniques that may improve the safety and efficiency of swallowing. A rationale for deciding which modifications to test in a given patient is discussed. The protocol has been used successfully in more than 350 patients. It has improved the efficiency and quality of our videofluorographic examinations.
本文介绍了进行视频荧光吞咽造影检查（VFSS）的详细方案，并描述了它是如何从其前身发展而来的。VFSS的目标兼具诊断和治疗作用。文中介绍了VFSS的准备工作，包括设备、食物准备以及对临床评估的简要讨论。VFSS程序的详细描述涵盖了患者的体位、所呈现的食物、所获取的视图、常用的喂养和吞咽方式的改变、标准化的观察项目集以及结果报告。文中还给出了偏离方案或中止研究的标准。当患者发生误吸时，VFSS不一定就此结束。事实上，对误吸的全面评估以及旨在减少误吸的操作的效果，是VFSS的主要目的。在研究过程中会根据经验测试喂养和吞咽方式的改变。这些改变包括可能提高吞咽安全性和效率的治疗性和代偿性技术。文中讨论了决定在特定患者中测试哪些改变的基本原理。该方案已成功应用于350多名患者。它提高了我们视频荧光造影检查的效率和质量。
