床边方法的准确性和成本,以确认鼻管的位置:一个诊断准确性研究
Mayara Carvalho Godinho Rigobello1, Claire Nierva Herrera2, Carlos Alberto Grespan Bonacim3
1Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. mayara.godinho@alumni.usp.br.
Journal of ultrasound
|October 15, 2024
概括
pH测量方法显示高准确性确认鼻管放置,但X射线仍然是黄金标准. 对于鼻管确认的床边方法的成本效益需要仔细考虑.
科学领域:
- 医疗器械 医疗器械
- 诊断的准确性 诊断的准确性
- 临床程序 临床程序
背景情况:
- 准确确认鼻管的放置对于患者的安全至关重要.
- 鼻管的盲目插入需要可靠的床边确认方法.
- 放射学是目前的黄金标准,但涉及辐射暴露和成本.
研究的目的:
- 评估三种床边方法 (超声波,胃外听,pH测量) 的诊断准确性,以确认鼻腔管的位置.
- 为了比较与这些床边方法与放射学相关的直接成本.
主要方法:
- 一项诊断准确性研究,涉及76名成年患者和87名鼻管插入.
- 床边方法 (超声波,腹膜听觉,pH测量) 连续应用并与放射图进行比较.
- 计算了每个确认方法的直接成本.
主要成果:
- 测量pH值显示了最高的灵敏度 (89.3%) 和特异性 (100%).
- 胃外听测显示出很好的准确性 (灵敏度为81.3%,特异性为83.3%).
- 超声波的准确性较低 (灵敏度为79.0%,特异性为66.7%),而pH测量是最昂贵的床边方法.
结论:
- 由于其已建立的可靠性,X光仍然是确认鼻管放置的主要方法.
- 虽然pH测量显示出高精度,但其成本比其他床边方法更高.
- 非放射学方法的成本效益应与床边鼻管确认的放射学相对权衡.
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