胃抽吸物pH测量在验证接受家庭肠内营养儿童鼻胃管位置中的诊断准确性：一项观察性诊断准确性研究。
Diagnostic accuracy of gastric aspirate pH measurement for verifying nasogastric tube placement in children receiving home enteral nutrition: An observational diagnostic accuracy study.
文献信息
| PMID | 42850777 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Hatice Pars |
| 作者单位 | Nursing Department, Faculty of Health Sciences, Yuksek İhtisas University, Ankara, Türkiye. |
| 期刊 | Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition |
| SCI 分区 | Q3 |
| IF | 3.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 准确验证鼻胃（NG）管位置对于预防并发症至关重要。尽管放射检查仍是参考标准，但重复成像对于接受家庭肠内营养的儿童并不实际。胃抽吸物pH测量被推荐为首选的床旁方法，但其在儿科家庭护理中的诊断准确性证据有限。
方法： 这项观察性诊断准确性研究纳入了40名通过NG管接受家庭肠内营养的儿童。在作为常规护理一部分安排的荧光吞咽评估前，立即测量一次胃抽吸物pH。使用标准化pH指示条，并以荧光检查结果作为参考标准。进行受试者工作特征（ROC）分析以确定样本得出的最佳pH截断值。
结果： 荧光检查确认27名儿童（67.5%）为胃内位置，13名（32.5%）为非胃内位置，包括高位和十二指肠管位置。胃内pH值低于非胃内位置（P < 0.001）。ROC分析确定样本得出的截断值为5.65。在预先设定的国际推荐临床阈值≤5.5时，pH测量在该队列中正确分类了所有管位置。护理者验证实践差异很大，许多人使用了不推荐作为独立技术的方法。
结论： 胃抽吸物pH测量在验证接受家庭肠内营养儿童的NG管位置方面显示出高诊断准确性。标准化pH检测可能为多方法管位置评估提供一种廉价、实用的组成部分。在这些发现能够推广至常规实践之前，需要更大规模的多中心研究。这些发现可能为护理者教育和标准化儿科家庭护理验证方案的制定提供信息。
英文摘要
BACKGROUND: Accurate verification of nasogastric (NG) tube placement is essential to prevent complications. Although radiography remains the reference standard, repeated imaging is impractical for children receiving home enteral nutrition. Gastric aspirate pH measurement is recommended as the preferred bedside method, but evidence of its diagnostic accuracy in pediatric home care is limited.
METHODS: This observational diagnostic accuracy study included 40 children receiving home enteral nutrition via NG tubes. Gastric aspirate pH was measured once immediately before a fluoroscopic swallowing assessment scheduled as part of routine care. Standardized pH indicator strips were used, and fluoroscopic findings served as the reference standard. Receiver operating characteristic (ROC) analysis was performed to identify a sample-derived optimal pH cutoff.
RESULTS: Fluoroscopy confirmed gastric placement in 27 children (67.5%) and nongastric placement in 13 (32.5%), including high and duodenal tube positions. Gastric pH values were lower than those in nongastric placements (P < 0.001). ROC analysis identified a sample-derived cutoff of 5.65. At the prespecified internationally recommended clinical threshold of ≤5.5, pH measurement correctly classified all tube locations in this cohort. Caregiver verification practices varied considerably, and many used methods not recommended as stand-alone techniques.
CONCLUSIONS: Gastric aspirate pH measurement showed high diagnostic accuracy for verifying NG tube placement in children receiving home enteral nutrition. Standardized pH testing may offer an inexpensive, practical component of multimethod tube-position assessment. Larger multicenter studies are needed before these findings can be generalized to routine practice. These findings may inform caregiver education and development of standardized pediatric home-care verification protocols.