Độ tin cậy của các phương pháp chẩn đoán không dụng cụ trong bệnh nuốt khó

HNO - Tập 62 - Trang 654-660 - 2014
S. Miller1, D. Kühn1, M. Jungheim1, M. Ptok1
1Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover, Deutschland

Tóm tắt

Các bác sĩ tai mũi họng và chuyên gia về giọng nói, trong bối cảnh sự thay đổi nhân khẩu học, sẽ cần phải đánh giá nhiều hơn về việc liệu một bệnh nhân có mắc chứng nuốt khó hay không và mức độ nghiêm trọng của nó là bao nhiêu. Việc kiểm tra video nội soi quá trình nuốt (FEES) cũng như chụp phim video X-quang (VFS) đã trở thành "tiêu chuẩn vàng" cho chẩn đoán xác nhận. Để hỗ trợ hoặc sử dụng như một phương pháp sàng lọc, các bảng câu hỏi chuẩn hóa về rối loạn nuốt thường được sử dụng hoặc các thử nghiệm nuốt thử nghiệm (PSV) được thực hiện theo nhiều giao thức khác nhau. Bài viết này đưa ra cái nhìn tổng quan phê phán về các phương pháp thường được sử dụng nhất trong thực tiễn lâm sàng và các tiêu chí đánh giá của chúng, đặc biệt là so với FEES và VFS. Đây là một bài tổng quan dựa trên việc tìm kiếm tài liệu có chọn lọc trong PubMed. Thông qua nghiên cứu, 48 phương pháp đã được xác định. Chúng có thể được phân loại thành phương pháp sàng lọc, các phương pháp chẩn đoán dụng cụ (tiêu chuẩn thực hiện và quy trình đánh giá) và đánh giá bằng bảng câu hỏi. Để chẩn đoán và đánh giá chứng nuốt khó dựa trên các bảng tiêu chí đánh giá, người sử dụng cần nhận thức rõ các lĩnh vực chỉ định thiết yếu cùng với ưu và nhược điểm tương ứng của những công cụ này. Khi xem xét các hồ sơ bệnh sử và đề xuất cho PSV, có sự chú ý đến việc độ đặc hiệu và độ nhạy tương đối thấp liên quan đến khả năng xâm nhập và tình trạng hít phải có thể xảy ra. Vì vậy, nếu những triệu chứng của chứng nuốt khó không rõ ràng và do đó không thể được đánh giá chắc chắn, thì FEES hoặc VFS là điều cần thiết.

Từ khóa

#Dysphagie #Diagnostik #FEES #VFS #Rüstmethoden

Tài liệu tham khảo

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