对pH测试进行前性观察研究,以确认正在进行的鼻胃管位置
Kate Glen1,2,3, Christine Elizabeth Weekes2,4, Merrilyn Banks2,3
1Nutrition and Dietetics, University College London Hospital, London, UK.
Journal of clinical nursing
|May 20, 2024
概括
对鼻胃管 (NGT) 放置的pH测试是不可靠的,导致营养和药物治疗的延迟. 这项研究强调了需要改进的方法,以确保准确的NGT定位和患者安全.
科学领域:
- 医疗器械 医疗器械
- 胃肠病学 胃肠病学
- 患者安全 患者安全
背景情况:
- 鼻胃管 (NGT) 位移可能会对患者造成伤害,因此需要可靠的方法来确认位置.
- 虽然初始NGT安置确认得到了充分研究,但通过持续测试检测NGT位移的证据有限.
- 国家卫生服务局 (NHS) 的指导方针建议进行pH测试,以确认NGT的位置,但对相关的X射线使用和错过的肠道营养/药物存在担忧.
研究的目的:
- 评估pH测试的可靠性,以确认持续的鼻胃管 (NGT) 位置.
- 为了记录与pH测试相关的并发症,以确认NGT位置.
主要方法:
- 根据STROBE指南进行的前性观察研究.
- 伦敦NHS信托基金会对136名NGT患者的医疗记录进行分析.
- 科恩的卡帕统计被用来确定pH测试的可靠性.
主要成果:
- 在1381个pH测试中,只有0.3%正确识别了NGT位移,0.07%未能在使用前检测到位移.
- 通过科恩的卡帕测量持续pH测试的可靠性是最小的 (0.29).
- 不准确的pH测试导致22.8%的患者需要X射线,17.6%缺少重要的肠道营养,18.4%缺少关键药物.
结论:
- 使用pH测试进行的NGT位置测试在防止使用位移管道方面被证明是无效的.
- 超过五分之一的患者需要X射线,因为pH测试不可靠,导致错过营养和药物治疗.
- 临床实践应仔细权衡移位管与营养/药物延迟的风险,需要研究替代NGT位置测试方法.
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