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目的:探索可靠的卒中患者床旁吞咽评估方法。方法:61例住院卒中患者均进行各种床旁吞咽评估筛查及电视透视检查,以后者为金标准探讨各方法的敏感度、特异度及阳性、阴性预测值。结果:六种独立床旁吞咽评估方法与金标准相比较的敏感度在60%~87%之间,特异度在76%~89%之间,阳性预测值在50%~69%之间,阴性预测值在86%~95%之间;几种评估方法作为平行试验联合应用时的敏感度在89%~98%之间,阴性预测值在94%~99%之间;几种方法作为序列试验应用时的特异度在97%~99%之间,阳性预测值在82%~90%之间。结论:根据不同方法的预测特点,可得到针对不同患者的、有效的床旁评估方法。床旁吞咽评估简单、有效、便捷,是临床工作中适宜的评估方法。
OBJECTIVE: To explore a reliable method for evaluating bedside swallowing in stroke patients. Methods: Sixty-one hospitalized stroke patients underwent bedside swallowing evaluation screening and TV fluoroscopy. The latter was the gold standard to explore the sensitivity, specificity and positive and negative predictive value of each method. Results: The sensitivities of six independent swallowing assessment methods to the gold standard ranged from 60% to 87% with a specificity of 76% to 89% and a positive predictive value of 50% to 69% The negative predictive values ranged from 86% to 95%. The sensitivity of several evaluation methods when used in combination as parallel assays ranged from 89% to 98% and the negative predictive values ranged from 94% to 99%. Several methods were used as The specificity of the sequence test was between 97% and 99%, and the positive predictive value was between 82% and 90%. CONCLUSION: Based on the predictive characteristics of different methods, an effective bedside assessment can be obtained for different patients. Bedside swallowing assessment is simple, effective and convenient, and is a suitable assessment method in clinical practice.