機能的嚥下障害スクリーニングテスト「反復唾液嚥下テスト」(the Repetitive Saliva Swallowing Test: RSST)の検討 (2)妥当性の検討 The Repetitive Saliva Swallowing Test (RSST) as a Screening Test of Functional Dysphagia (2) Validity of RSST
131名の機能的嚥下障害患者の「反復唾液嚥下テスト」(the Repetitive Saliva Swallowing Test: RSST)と嚥下ビデオレントゲン造影(videofluorography : VF)所見を比較し,RSSTの妥当性を検討した.RSSTはVF所見と相関が高く,カットオフ値として3回/30秒間が妥当であると思われた.誤嚥の有無の判別に関する感度と特異度は,0.98,0.66と,感度が非常に高かった.摂食・嚥下障害の診断・評価としては,まずRSSTでスクリーニングを行い,3回/30秒間未満の場合はさらに詳細な病歴,身体所見をとり,必要と判断されればVFを行い,治療方針を決定するのが適当である.
We developed the "Repetitive Saliva Swallowing Test (RSST)" to safely and simply screen patients for functional dysphagia. We examined 131 patients with functional dysphagia by using RSST and compared its findings with those of videofluorography (VF) to establish the validity of RSST. RSST findings had a high correlation with those of VF. Especially in examining aspiration, there was statistically significant difference between patients with RSST≧3/30 sec and those with RSST <3. We concluded that the criteria of twice or less per 30 sec, which was set as the screening value of RSST, was appropriate. The sensitivity and specificity of RSST in screening aspiration were 0.98 and 0.66 respectively, proving that RSST had very high sensitivity. It seems reasonable to set the screening value of RSST at twice or less per 30 sec. When evaluating dysphagia, it seems appropriate to perform RSST first. When RSST presents the value of twice or less per 30 sec, clinical history and medical information of the patients should be investigated, and, if necessary, VF should be performed to decide specific treatment.