Bedside Assessment of Swallow in Stroke_West China Medical Journal

Authors：

YUAN Qang , ZHOU Hongyu

Department of Neurology，West China Hospital，Sichuan Universtty，Chengdu 610041，China;

Corresponding?author：

Keywords：

卒中; 吞咽困難; 誤吸

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摘要:目的:探索可靠的卒中患者床旁吞咽評估方法。方法：61例住院卒中患者均進行各種床旁吞咽評估篩查及電視透視檢查，以后者為金標準探討各方法的敏感度、特異度及陽性、陰性預測值。結果:六種獨立床旁吞咽評估方法與金標準相比較的敏感度在60%～87%之間，特異度在76%～89%之間，陽性預測值在50%～69%之間，陰性預測值在86%～95%之間；幾種評估方法作為平行試驗聯合應用時的敏感度在89%～98%之間，陰性預測值在94%～99%之間；幾種方法作為序列試驗應用時的特異度在97%～99%之間，陽性預測值在82%～90%之間。結論：根據不同方法的預測特點，可得到針對不同患者的、有效的床旁評估方法。床旁吞咽評估簡單、有效、便捷，是臨床工作中適宜的評估方法。

Citation： YUAN Qang,ZHOU Hongyu. Bedside Assessment of Swallow in Stroke. West China Medical Journal, 2009, 24(1): 35-37. doi: Copy

1.	Deborah JC，David G，Lalit Kalra.Early assessments of dysphagia and aspiration risk in acute stroke patients[J].Stroke，2003，34:1252-1257..
2.	Cameron SM，Lynsey BM，Jeremy BP，et al.Risk factors for chest infection in acute stroke[J].Stroke，2007，38:2284-2291..
3.	Chai J，Chu FCS，Chow TW，et al.Prevalence of malnutrition and its risk factors in stoke patients residing in an infirmary[J].Singapore Med J，2008，49（4）:290..
4.	Charles DA，Wolfe MD，David OC，et al.Poststroke survival for BlackCaribbean Populations in Barbados and South London[J].Stroke，2006，37:1991..
5.	O’Dongghue S，Bagnall A.Videofluoroscopic evaluation in the assessment of swallowing disorders in paediaric and adult populations[J].Folia Phoniatr Logop，1999，51:158-171..
6.	Smithard DG，O’Neill PA，England RE，et al.The natural history of dysphagia following a stroke[J].Dysphagia，1997，12:188-193..
7.	Horner J，Brazer SR，Massey EW.Aspiration in bilateral stroke patients:a validation study[J].Neuroloty，1993，43:430-433..
8.	Linden P，Kuhlemeier KV，Patterson C.The probability of correctly predicting subglottic penetration from clinical obswrvations[J].Dysphagia，1993，8:170-179..
9.	Stanners AJ，Chapman AN，Bamford JM.Clinical predictors of aspiration soon after stroke[J].Age Ageing，1993，2:A47.Abstract.
10.	〖ZK（#〗Daniels SK，McAdam CP，Brailey K，et al.Clinical assessment of swallowing andprediction of dysphagia severity[J].Am J Speech Lang Path，1997，6:17-24..
11.	DePippo KL，Holas MA，Reding MJ.Validation of the 3oz water swallow test for aspiration following stroke[J].Arch Neurol，1992，49:1259-1261..
12.	Hinds NP，Wiles CM.Assessment of swallowing and referral to speech and language therapists in acute stroke[J].QJM，1998，91:829-835..
13.	Edith E，Wolfgang S，Ewald S，et al.Videofluoroscopic assessment of patients with dysphagia[J].Am J Roentgennol，2002，178:393-398..
14.	Ding RY，Logemann JA.Pneumonia in stroke patients:A retrospective study[J].Dysphagia，2000，15:51-57..
15.	Hinchey JA，Shephard T，Furie K，et al.Formal dysphagia screening protocols prevent pneumonia[J].Stroke，2005，36(9):1972-1976..
16.	Wilcox F，Liss JM，Siegel GM.Interjudge agreement in videofuroscopic studies of swallowing[J].J Speech Hear Res，1996，39:144-152..
17.	Hoals MA，Depipo KL，Reding MJ.Aspiration and relative risk of medical complications following stroke[J].Arch Neurol，1994，51:1051-1053..
18.	Kidd D，Lawson J，Nesbitt R，et al.Aspiration in acute stroke:a clinical study with videofluroscopy[J].QJM，1993，86:825-829..

1. Deborah JC，David G，Lalit Kalra.Early assessments of dysphagia and aspiration risk in acute stroke patients[J].Stroke，2003，34:1252-1257..
2. Cameron SM，Lynsey BM，Jeremy BP，et al.Risk factors for chest infection in acute stroke[J].Stroke，2007，38:2284-2291..
3. Chai J，Chu FCS，Chow TW，et al.Prevalence of malnutrition and its risk factors in stoke patients residing in an infirmary[J].Singapore Med J，2008，49（4）:290..
4. Charles DA，Wolfe MD，David OC，et al.Poststroke survival for BlackCaribbean Populations in Barbados and South London[J].Stroke，2006，37:1991..
5. O’Dongghue S，Bagnall A.Videofluoroscopic evaluation in the assessment of swallowing disorders in paediaric and adult populations[J].Folia Phoniatr Logop，1999，51:158-171..
6. Smithard DG，O’Neill PA，England RE，et al.The natural history of dysphagia following a stroke[J].Dysphagia，1997，12:188-193..
7. Horner J，Brazer SR，Massey EW.Aspiration in bilateral stroke patients:a validation study[J].Neuroloty，1993，43:430-433..
8. Linden P，Kuhlemeier KV，Patterson C.The probability of correctly predicting subglottic penetration from clinical obswrvations[J].Dysphagia，1993，8:170-179..
9. Stanners AJ，Chapman AN，Bamford JM.Clinical predictors of aspiration soon after stroke[J].Age Ageing，1993，2:A47.Abstract.
10. 〖ZK（#〗Daniels SK，McAdam CP，Brailey K，et al.Clinical assessment of swallowing andprediction of dysphagia severity[J].Am J Speech Lang Path，1997，6:17-24..
11. DePippo KL，Holas MA，Reding MJ.Validation of the 3oz water swallow test for aspiration following stroke[J].Arch Neurol，1992，49:1259-1261..
12. Hinds NP，Wiles CM.Assessment of swallowing and referral to speech and language therapists in acute stroke[J].QJM，1998，91:829-835..
13. Edith E，Wolfgang S，Ewald S，et al.Videofluoroscopic assessment of patients with dysphagia[J].Am J Roentgennol，2002，178:393-398..
14. Ding RY，Logemann JA.Pneumonia in stroke patients:A retrospective study[J].Dysphagia，2000，15:51-57..
15. Hinchey JA，Shephard T，Furie K，et al.Formal dysphagia screening protocols prevent pneumonia[J].Stroke，2005，36(9):1972-1976..
16. Wilcox F，Liss JM，Siegel GM.Interjudge agreement in videofuroscopic studies of swallowing[J].J Speech Hear Res，1996，39:144-152..
17. Hoals MA，Depipo KL，Reding MJ.Aspiration and relative risk of medical complications following stroke[J].Arch Neurol，1994，51:1051-1053..
18. Kidd D，Lawson J，Nesbitt R，et al.Aspiration in acute stroke:a clinical study with videofluroscopy[J].QJM，1993，86:825-829..

West China Medical Journal

Bedside Assessment of Swallow in Stroke

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