Clinical Application Value Of Video Fluoroscopy Swallowing Study In Post-stroke Dysphagia

Objective:Through analyzing difference of the aspiration’s detection rate for post-stroke dysphagia detected by video fluoroscopy swallowing study(VFSS) and clinical evaluation respectively, the more accurate method is choose for clinical diagnosis. The difference of aspiration incidence for patients with bulbar paralysis and pseudobulbar palsy is study. For the patients with aspiration, the effects of different traits of food and different amount of the same food on the incidence of aspiration were also studied. The relationship between post-stroke dysphagia and the injury position, different food concentration and amount of the patients using VFSS is discussed, which will provide evidence for clinical diagnosis and rehabilitation treatment.Methods:In accordance with the definition of the Scotland national guidelines for post-stroke dysphagia, 56 cases of patients with dysphagia, from The First Affiliated Hospital of Shanxi Medical University during March 2014 to February 2016,were choose and divided into bulbar palsy, pseudobulbar palsy receptively according to the site of injury. And then,VFSS and clinical swallowing function evaluation were completed.(1)Drinking water test was used for clinical assessment. Cough situation of the patients having 30 ml water one-time will be observed, Cough is positive, otherwise the contrary. For VFSS test,patients are orally administered 20 ml of 76% diatrizoate. And then, recording the swallowing process in real time using dynamic sequence, observing whether contrast agent go into airway below glottis, if yes, recorded as positive. Meanwhile, analyzing difference of aspiration detection rate for two kinds of methods.(2) In this group, patients with Aspiration are firstly selected using VFSS. Then patients swallow 3ml and 10 ml liquid and10 ml paste food mixed with contrast agent respectively. At the same time, observing how different characters and different amounts foods affect aspiration rate. And then SPSS17.0statistical software is used to execute chi square test for all indexes collected using thesemethods above.,the differences were statistically significant(P < 0.05).Results:(1)For the detection rate of aspiration, VFSS is higher than drinking water test.(2)In the pharyngeal, aspiration incidence of bulbar paralysis is higher than pseudobulbar paralysis.(3) Aspiration rate of patients having Liquid food is higher than having paste food. And Aspiration rate for 3ml is lower than 10 ml.Conclusion:(1)VFSS may detect occult aspiration, which clinical evaluation cannot detect, and it improves the aspiration’s detection rate.(2)Due to aspiration incidence of patients with the bulbar paralysis is higher, VFSS should be conventional treatment.(3) Pasty foods and smaller amount in one times can help patients reduce the incidence of aspiration. Therefore,VFSS can be as an important clinical tool for the detection and assessment of post-stroke dysphagia. And it is instructively important for rehabilitation.