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

Application of fibreoptic endoscopic evaluation of swallowing in the evaluation of dysphagia after radio-chemical therapy of nasopharyngeal carcinoma

摘要:

目的 探讨纤维内镜吞咽功能检查(FEES)在鼻咽癌放/化疗后吞咽障碍评估中的应用价值。方法 对37例经放/化疗后的鼻咽癌患者进行安德森吞咽障碍量表检查(MDADI)、FEES、吞咽X线荧光透视检查，对检查结果进行分析。结果 FEES吞咽障碍的阳性检测率为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＜0.05)，差异具有统计学意义。FEES与吞咽X线荧光透视检查的一致性较强(Kappa值为0.358)。FEES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 FEES可应用于鼻咽癌放/化疗后吞咽障碍的评估，值得临床推广。

关键词:鼻咽癌;纤维内镜吞咽功能检查;吞咽障碍;评估方法

Abstract:

Objective To investigate the application value of fibreoptic endoscopic evaluation of swallowing (FEES) and evaluate the correlation between dysphagia and radio-chemical therapy of nasopharyngeal cancer(NPC).Methods It was analyzed for the results of M.D.Anderson Dysphagia Inventory(MDADI), FEES and Video Fluoroscopic Swallowing Study(VFSS) in 37 patients with NPC.Results The positive rate of FEES detection was higher(70.27%) than that of VFSS detection(48.65%) for dysphagia, and the difference was statistically significant between them(P<0.05). FEES are consistent with VFSS (Kappa of 0.358). The consistency between FEES and MDADI (Kappa value of 0.340) was better than the consistency between VFSS and MDADI (Kappa value of 0.194).Conclusion FEES can be applied in the evaluation of dysphagia after the radio-chemical therapy of NPC, which is worth promotion in clinic.

Key words:Nasopharyngeal cancer;Fibreoptic endoscopic evaluation of swallowing (FEES);Dysphagia;Evaluation methods