摘要
目的:探讨纤维喉镜吞咽检查对鼻咽癌放射治疗后咽腔期吞咽评估的价值。方法:对53例鼻咽癌放射治疗后存在吞咽困难的患者进行纤维喉镜吞咽评估及食管造影吞咽评估检查,应用食物残留量表和食物渗透及误吸量表进行评分,对结果进行分析。结果:纤维喉镜检查及食管造影检查对于渗透及误吸的检出一致性流质食物(κ=0.56,95%CI 0.38~0.73)和粥水样食物(κ=0.64,95%CI 0.43~0.81)均为一般。纤维喉镜对于流质食物及粥水样食物误吸检出率为60%、51%,食管造影对于流质食物及粥水样食物误吸检出率为70%和53%,差异无统计学意义。纤维喉镜对于流质食物及粥水样食物渗透检出率为49%、27%,食管造影对于流质食物及粥水样食物渗透检出率为42%和20%,差异无统计学意义。纤维喉镜检查及食管造影检查对于食物残留的检出一致性流质食物(κ=0.38,95%CI 0.12~0.62)和粥水样食物(κ=0.66,95%CI 0.44~0.86)均为一般。纤维喉镜及食管造影对于粥水样食物检出率为43%和45%,差异无统计学意义,对于流质食物检出率为44%和24%,差异有统计学意义。结论:纤维喉镜可应用于鼻咽癌放射治疗后咽腔期吞咽评估,可应用于咽腔期的食物残留、误吸及渗透的评估。
Objective: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.Method: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.Result:The agreement in the detection of penetration and aspiration between FEES and VF of liquid(κ=0.56,95%CI 0.38-0.73)and porridge(κ=0.64,95%CI 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%CI0.12-0.62)and porridge(κ=0.66,95%CI 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.Conclusion:FEES is an effective and valuable tool for evaluating pharyngeal dysphagia in post-irradiated patients with nasopharyngeal carcinoma.
作者
张剑利
陈伟雄
黎景佳
陈瑞开
邝德斌
杨冠英
冯红梅
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)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2020年第2期158-161,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
佛山市科技攻关项目(No:2016AB002171).
关键词
吞咽障碍
鼻咽肿瘤
放射治疗
喉镜
dysphagia
nasopharyngeal neoplasms
radiotherapy
laryngocopes
