李全; 张静; 吴洪芸; 单小峰; 贺洋; 杨悦

doi:10.3760/cma.j.cn112144-20210608-00286

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口腔癌曼恩吞咽功能量表中文版的修订及信效度检验

中华口腔医学杂志, 2021,56(9) : 914-919. DOI: 10.3760/cma.j.cn112144-20210608-00286

摘要

目的

翻译肿瘤曼恩吞咽功能量表，根据口腔癌手术患者进行修订，形成口腔癌曼恩吞咽功能量表（Mann assessment of swallowing ability-oral cancer，MASA-OC）并在口腔癌术后患者中验证其信效度。

方法

通过直译、回译、专家评议和预调查形成中文版MASA-OC；采用便利抽样法选取北京大学口腔医学院·口腔医院口腔颌面外科的107例口腔癌术后患者进行吞咽功能评估，检验MASA-OC量表的信效度，以容积-黏度吞咽测试（volume-viscosity swallow test，V-VST）为诊断工具，确定MASA-OC量表诊断吞咽障碍的界值和诊断效能。

结果

MASA-OC量表共15个条目，量表内部一致性克龙巴赫 α系数为0.868；内容效度结果显示，量表平均内容效度指数为1.00，条目内容效度指数为1.00；评定者间信度显示，研究者与另一评估者总分的组内相关系数为0.985；以V-VST的评估结果为诊断标准，MASA-OC诊断吞咽障碍最佳界值为105分，该界值处灵敏度为95.0%，特异度为92.5%，阳性预测值为97.4%，阴性预测值为86.2%。

结论

MASA-OC量表引进过程科学，信效度良好，诊断可靠，可作为口腔癌术后患者吞咽障碍的有效评估工具。

引用本文: 李全, 张静, 吴洪芸, 等. 口腔癌曼恩吞咽功能量表中文版的修订及信效度检验 [J] . 中华口腔医学杂志, 2021, 56(9) : 914-919. DOI: 10.3760/cma.j.cn112144-20210608-00286.

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口腔癌的发病率逐年上升，居头颈部肿瘤的第二位^［1］。目前口腔癌患者多采用根治性手术为主的综合治疗，手术损伤口腔解剖结构和神经组织，导致一定程度的口腔功能障碍，其中吞咽障碍发生率为66%~88%^{［2, 3, 4］}。吞咽障碍可引发营养不良、脱水、误吸、焦虑抑郁等一系列不良后果，严重者可导致吸入性肺炎或窒息，患者生命质量严重下降^{［5, 6］}。研究显示早期识别和阶段性评估可减少口腔及口咽癌术后患者吞咽障碍和营养不良的发生率^［7］，因此，口腔癌术后患者吞咽功能的评估尤为重要。

贡献者信息

李全

北京大学口腔医学院·口腔医院口腔颌面外科　国家口腔医学中心　国家口腔疾病临床医学研究中心　口腔数字化医疗技术和材料国家工程实验室　口腔数字医学北京市重点实验室　100081

张静

吴洪芸

单小峰

贺洋

杨悦

通信作者

杨悦

Email：yangyuekq@163.com

关键词

吞咽障碍; 口腔癌; 信度; 效度;

作者声明

作者贡献声明

李全：酝酿和设计研究、实施研究、采集数据、分析数据、撰写文章；张静：实施研究、采集数据；吴洪芸、单小峰、贺洋：实施研究、对文章的知识性内容作批评性审阅；杨悦：酝酿和设计研究、对文章的知识性内容作批评性审阅、技术或材料支持、指导、支持性贡献

引用本文：

李全, 张静, 吴洪芸, 等. 口腔癌曼恩吞咽功能量表中文版的修订及信效度检验[J]. 中华口腔医学杂志, 2021, 56(9): 916-921. DOI: 10.3760/cma.j.cn112144-20210608-00286.

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出版日期：2021-09-09

收稿日期：2021-06-08

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陈素红

Original Article

Chinese version of the Mann assessment of swallowing ability-oral cancer: revision and evaluation of reliability and validity

Li Quan, Zhang Jing, Wu Hongyun, Shan Xiaofeng, He Yang, Yang Yue

Published 2021-09-09

Cite as Chin J Stomatol, 2021, 56(9): 914-919. DOI: 10.3760/cma.j.cn112144-20210608-00286

Abstract

Objective

To translate and revise the Mann assessment of swallowing ability-cancer (MASA-C) into Chinese according to postoperative patients with oral cancer and to evaluate the reliability and validity of Mann assessment of swallowing ability-oral cancer (MASA-OC) in postoperative patients with oral cancer.

Methods

The MASA-C was translated into Chinese through pre-translation, reconciliation and back translation, then the Chinese MASA-C was revised to MASA-OC according to postoperative patients with oral cancer by expert panel and pre-investigation. One hundred and seven patients recieved oral cancer surgery in Peking University School and Hospital of Stomatology were selected by convenient sampling and investigated to evaluate the reliability and validity of the MASA-OC. The volume viscosity swallow test (V-VST) was used to determine the best diagnosis threshold of MASA-OC for dysphagia. The sensitivity, specificity, positive predictive value and negative predictive value were calculated and analyzed.

Results

The Chinese MASA-OC contained 15 items. The Cronbach′s coefficient was 0.868. The content validity showed that the scale-level content validity index (S-CVI) was 1.00, the item-level content validity index (I-CVI) was 1.00 and the intraclass correlation coefficient between the researchers and the other reviewers was 0.985. The best diagnosis threshold of MASA-OC for dysphagia was 105, the sensitivity was 95.0%, the specificity was 92.5%, the positive predictive value was 97.4% and the negative predictive value was 86.2%.

Conclusions

The introduction process of MASA-OC was scientific. MASA-OC showed good reliability and validity and reliable diagnostic efficacy MASA-OC could be used as an effective tool for scientific research and clinical practice of dysphagia in postoperative patients of oral cancer.

Key words:

Deglutition disorders; Oral cancer; Reliability; Validity

Contributor Information

Li Quan

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology &

National Center of Stomatology &