纤维内镜吞咽功能检查在鼻咽癌放(化)疗后吞咽障碍评估中的应用
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1.邵阳市中心医院耳鼻咽喉头颈外科;2.中南大学湘雅三医院耳鼻咽喉头颈外科;3.邵阳市中心医院医学影像中心

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湖南省技术创新引导计划 ——临床医疗技术创新引导项目(编号:2018SK51808);邵阳市科技计划项目(编号:2015GX56);邵阳市指导性科技计划项目(编号:2014ZD23)


Application of Fibreoptic Endoscopic Evaluation of Swallowing in the evaluation of dysphagia after radio(chemical)therapy of nasopharyngeal carcinoma
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Department of Otolaryngology-Head and Neck Surgery,The Central Hospital of Shaoyang

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    摘要:

    目的:探讨纤维内镜吞咽功能检查(Fibreoptic endoscopic evaluation of swallowing,FEES)在鼻咽癌放(化)疗后吞咽障碍评估中的应用价值。方法:对经放(化)疗后的鼻咽癌患者37例进行安德森吞咽障碍量表检查(M.D.Anderson Dysphagia Inventory,MDADI),纤维内镜吞咽功能检查(Fibreoptic endoscopic evaluation of swallowing,FEES),吞咽 X 线荧光透视检查(Video Fluoroscopic Swallowing Study, VFSS) ,对检查结果进行分析。结果:纤维内镜吞咽功能检查吞咽障碍的阳性检测率70.27%,高于吞咽 X 线荧光透视检查的吞咽障碍阳性检测率48.65%,P值0.029(P<0.05),差异有显著性统计学意义。纤维内镜吞咽功能检查与吞咽 X 线荧光透视检查的一致性较强(Kappa值为0.358)。纤维内镜吞咽功能检查与量表评估检查一致性(Kappa值为0.340)优于吞咽 X 线荧光透视检查与量表评估检的一致性(Kappa值为0.194)。结论:纤维内镜吞咽功能检查可应用于鼻咽癌放(化)疗后吞咽障碍的评估,值得推广。

    Abstract:

    Objective: To investigate the application value of Fibreoptic Endoscopic Evaluation of Swallowing (FEES)in the evaluation of dysphagia after radiotherapy (chemical) therapy of nasopharyngeal cancer.Methods: 37 NPC patients were treated in M.D.Anderson Dysphagia Inventory(MDADI), Fibreoptic Endoscopic Evaluation of Swallowing(FEES), Video Fluoroscopic Swallowing Study(VFSS), and the examination results were analysed. Results: The positive detection rate of FEES was 70.27%, which was higher than 48.65% in VFSS, P value was 0.0259 (P<0.05),the difference was statistically significant. FEES has good consistency with VFSS (Kappa of 0.358).FEES and MDADI consistency (Kappa value of 0.340) were better than the consistency between VFSS and MDADI (Kappa value of 0.194).Conclusion: FEES can be applied in the evaluation of dysphagia after NPC radio(chemical)therapy, which is worth promotion.

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  • 收稿日期:2021-10-06
  • 最后修改日期:2021-11-24
  • 录用日期:2021-11-24
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