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应用颏下超声作为鼻胃管拔除指征的筛查工具：一项具有真实世界应用的初步研究

Applying Submental Ultrasound as a Screening Tool for Nasogastric Tube Removal Indication: A Pilot Study with Real-world Application.

临床研究咽喉科IF 3.5Q1

文献信息

PMID	42962677
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Hsueh-Ching Lin 查看其他 5 位作者 Chih-Yi Wang；Rou-Tsern Chen；Chih-Yu Liu；Yao-Wen Kuo；Chin-Chung Shu
作者单位	College of Medicine, National Taiwan University, School of Medicine, Taipei, Taiwan. 查看其他 6 条单位信息 National Taiwan University Hospital, Department of Medical Education, Taipei, Taiwan.；National Taiwan University Hospital, Department of Nursing, Taipei, Taiwan.；College of Medicine, National Taiwan University, Department of Internal Medicine, Taipei, Taiwan.；National Taiwan University Hospital, Department of Integrated Diagnostics & Therapeutics, Taipei, Taiwan.；College of Medicine, National Taiwan University, Graduate Institute of Clinical Medicine, Taipei, Taiwan.；National Taiwan University Hospital, Department of Internal Medicine, Taipei, Taiwan.
期刊	Ultraschall in der Medizin (Stuttgart, Germany : 1980)
SCI 分区	Q1
IF	3.5
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

目的： 鼻胃管（NGT）在住院患者中使用普遍。然而，缺乏一种便捷且客观的工具来评估患者吞咽功能以决定是否拔除NGT。使用颏下超声做出NGT拔除决策的可行性仍不清楚。
材料与方法： 本初步研究纳入2023年3月至2025年12月期间接受颏下超声检查以评估NGT拔除的患者。患者按不同检查者分为推导队列和验证队列。我们首先测量静息状态下下颌骨-舌骨距离及吞咽时的最短距离，然后计算舌骨最大位移。
结果： 在推导队列中，NGT组（n=31）的最大位移短于对照组（n=27）（1.26 vs. 1.83 cm，p ≤ 0.001），且“NGT未拔除”亚组（NG-NR，n=21）的位移短于“NGT拔除”亚组（NG-R，n=10）（1.09 vs. 1.63 cm，p = 0.006）。在验证队列中，NG-NR亚组（n=18）的位移短于NG-R亚组（n=6）（1.36 vs. 1.89 cm，p ≤ 0.001）。在推导队列中，位移区分NG-NR与NG-R亚组的AUROC为0.805。截断值1.32 cm的敏感性为80.0%，特异性为81.0%。在验证队列中，AUROC为0.836。在年龄和性别匹配的验证队列中，AUROC为0.831。评分者间一致性良好。
结论： 鉴于其在识别NG-R患者方面具有良好的判别性能、评分者间一致性及便捷性，颏下超声可能是一种有效的筛查工具，用于识别适合在拔除NGT前开始吞咽训练的后急性期NGT患者。

英文摘要

ABSTRACT: PURPOSE: Nasogastric tube (NGT) usage is common among inpatients. However, there is a lack of a convenient and objective tool for assessing a patient's swallowing function for NGT removal. The feasibility of using submental ultrasound for making decisions regarding NGT removal remains unclear.
ABSTRACT: MATERIALS AND METHODS: This pilot study included patients with NGTs who underwent submental ultrasound examination for NGT removal from March 2023 to December 2025. Patients were divided into derivation and validation cohorts by different examiners. We first measured the resting mandible-hyoid distance and shortest distance when swallowing and then calculated the maximum hyoid bone displacement.
ABSTRACT: RESULTS: In the derivation cohort, the maximum displacement was shorter in the NGT group (n = 31) than in the control group (n = 27) (1.26 vs. 1.83 cm, p ≤ 0.001), and the displacement was shorter in the "NGT not removed" subgroup (NG-NR, n = 21) than in the "NGT removed" subgroup (NG-R, n = 10) (1.09 vs. 1.63 cm, p = 0.006). In the validation cohort, the displacement was shorter in the NG-NR subgroup (n = 18) than in the NG-R subgroup (n = 6) (1.36 vs. 1.89 cm, p ≤ 0.001). In the derivation cohort, the displacement showed an AUROC of 0.805 for distinguishing between the NG-NR and NG-R subgroups. A cut-off value of 1.32 cm yielded a sensitivity of 80.0% and a specificity of 81.0%. In the validation cohort, the AUROC was 0.836. In the age- and sex-matched validation cohort, the AUROC was 0.831. The interrater consistency was good.
ABSTRACT: CONCLUSION: Given its good discriminatory performance with regard to NG-R patient identification, interrater consistency, and convenience, submental ultrasound might be an effective screening tool for identifying suitable postacute NGT patients to start swallowing training before NGT removal.