万桂芳,张耀文,史静,等.改良容积粘度测试在吞咽障碍评估中的灵敏性及特异性研究[J].中华物理医学与康复杂志,2019,41(12):900-904
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| 改良容积粘度测试在吞咽障碍评估中的灵敏性及特异性研究 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.12.004 |
| 中文关键词: 吞咽障碍 容积粘度测试 改良 评估 |
| 英文关键词: Dysphagia Volume and viscosity swallowing test Evaluations |
| 基金项目:广东省科技计划项目（2016A010105005），国家自然科学基金面上项目（81672256） |
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| 中文摘要: |
| 目的 探索改良容积粘度测试（VVST-CV）在吞咽障碍安全性、有效性指标的灵敏性、特异性。 方法 对容积粘度测试（VVST）中溶剂、容积、粘度、测试指标进行改良，使用改良容积粘度测试对吞咽障碍患者89例进行评估，记录其安全性指标（咳嗽、声音变化、血氧饱和度下降≥3%）、有效性指标（唇闭合不良、口腔残留、咽腔残留、分次吞咽）的阳性率，并与吞咽造影检查（VFSS）的渗漏、误吸、残留的阳性率对比，计算改良容积粘度测试对吞咽安全和有效性指标的灵敏度、特异度、阳性预测值和阴性预测值。 结果 改良容积粘度测试对吞咽障碍、安全性受损和有效性受损的敏感度分别为0.97、0.85和0.95。代表安全性的咳嗽、声音变化和血氧饱和度下降三项指标的敏感度分别为0.65、0.60和0.42，阳性预测值分别为0.98、0.94和0.94。 结论 改良容积粘度测试简单可行，灵敏度较高，可广泛应用在吞咽障碍的评估中。 |
| 英文摘要: |
| Objective To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice. |
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