留置鼻胃管位置判断方法应用及研究现状_West China Medical Journal

Authors：

涂双燕 , 苗晓慧 ,  杨蓉

四川大学华西医院神经内科（成都 610041）;

Corresponding author：

杨蓉, Email: hxyangrong2004@126.com

Keywords：

留置鼻胃管; 位置判断方法; 研究现状

DOI：

10.7507/1002-0179.201608256

Video：

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针对目前国内外临床确认留置鼻胃管位置的方法，该文分析和总结了各国相关的指南或专家推荐，对检测依据、相关研究和国内外应用情况现状进行了综述，以期为临床护理工作者提供参考和借鉴。通过引进国外适用方法，应用于临床留置鼻胃管位置的正确判断，有利于保障患者鼻饲安全，减轻患者痛苦，减少不良事件的发生，促进护理质量的持续改进。

Citation： 涂双燕, 苗晓慧, 杨蓉. 留置鼻胃管位置判断方法应用及研究现状. West China Medical Journal, 2017, 32(10): 1633-1637. doi: 10.7507/1002-0179.201608256 Copy

1.	蔡威. 欧洲肠外和肠内营养学会继续教育专用课本: 临床营养基础. 3 版. 上海: 复旦大学出版社, 2012: 216-217.
2.	李小寒, 尚少梅. 基础护理学. 3 版. 北京: 人民卫生出版社, 2007: 210-211.
3.	Meyers M, Ghahremani GG. Complications of gastrointestinal intubation. New York: Iatrogenic Gastrointestinal Complications, 1981: 65-89.
4.	Galloway DC, Grudis J. Inadvertent intracranial placement of a nasogastric tube through a basal skull fracture. South Med J, 1979, 72(2): 240-241.
5.	Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube: review of safe practice. Interact Cardiovasc Thorac Surg, 2005, 4(5): 429-433.
6.	Roka YB, Shrestha M, Puri PR, et al. Fatal inadvertent intracranial insertion of a nasogastric tube. Neurol India, 2010, 58(5): 802-804.
7.	Ellett ML. What is known about methods of correctly placing gastric tubes in adults and children. Gastroenterol Nurs, 2005, 27(6): 253-259; quiz 260-261.
8.	彭爱珍, 刘施岚. 一例胃管置入误入气管无典型症状的临床分析. 健康必读: 中旬刊, 2013, 12(8): 673.
9.	郭军荣. 判断胃管在胃内的第四种方法. 医学信息: 下旬刊, 2013, 26(10): 574.
10.	Metheny N, Mcsweeney M, Wehrle MA, et al. Effectiveness of the auscultatory method in predicting feeding tube location. Nurs Res, 1990, 39(5): 262-267.
11.	Elpern EH, Killeen K, Talla E, et al. Capnometry and air insufflation for assessing initial placement of gastric tubes. Am J Crit Care, 2007, 16(6): 544-549; quiz 550.
12.	Clinical rounds. Confirming correct placement of NG tubes. Nursing, 2006, 36(1): 33-35.
13.	De Boer JC, Smit BJ, Mainous RO. Nasogastric tube position and intragastric air collection in a neonatal intensive care population. Adv Neonatal Care, 2009, 9(6): 293-298.
14.	Chau JP, Lo SH, Thompson DR, et al. Use of end-tidal carbon dioxide detection to determine correct placement of nasogastric tube: a meta-analysis. Int J Nurs Stud, 2011, 48(4): 513-521.
15.	D’souza CR, Kilam SA, D’souza U, et al. Pulmonary complications of feeding tubes: a new technique of insertion and monitoring malposition. Can J Surg, 1994, 37(5): 404-408.
16.	Burns SM, Carpenter R, Truwit JD. Report on the development of a procedure to prevent placement of feeding tubes into the lungs using end-tidal CO<sub>2</sub> measurements. Crit Care Med, 2001, 29(5): 936-939.
17.	Kindopp AS, Drover JW, Heyland DK. Capnography confirms correct feeding tube placement in intensive care unit patients. Can J Anaesth, 2001, 48(7): 705-710.
18.	Thomas BW, Falcone RE. Confirmation of nasogastric tube placement by colorimetric indicator detection of carbon dioxide: a preliminary report. J Am Coll Nutr, 1998, 17(2): 195-197.
19.	Araujo-Preza CE, Melhado ME, Gutierrez FJ, et al. Use of capnometry to verify feeding tube placement. Crit Care Med, 2002, 30(10): 2255-2259.
20.	Howes DW, Shelley ES, Pickett W. Colorimetric carbon dioxide detector to determine accidental tracheal feeding tube placement. Can J Anaesth, 2005, 52(4): 428-432.
21.	Meyer P, Henry M, Maury E, et al. Colorimetric capnography to ensure correct nasogastric tube position. J Crit Care, 2009, 24(2): 231-235.
22.	王瑞玉, 方梦明. 呼气末二氧化碳浓度监测下经气管导管导入胃管的体会. 护理学杂志, 1997, 12(6): 325.
23.	李燕, 高文斌, 陶喜民. 呼气末二氧化碳浓度监测在急置胃管中的应用. 中华急诊医学杂志, 2004, 13(4): 286.
24.	葛媚. 呼气末二氧化碳浓度监测在危重患儿急置胃管中的应用. 青海医药杂志, 2012, 42(7): 52-53.
25.	Rulli F, Galatà G, Villa M, et al. A simple indicator of correct nasogastric suction tube placement in children and adults. Endoscopy, 2007, 39(Suppl 1): E237-E238.
26.	Kearns PJ. Evaluation of diagnostic tests: verification of feeding tube placement using electromagnetic principles. Nutr Clin Pract, 1997, 12(1 Suppl): S61-S65; discussion S66.
27.	Tobin RW, Gonzales AJ, Golden RN, et al. Magnetic detection to position human nasogastric tubes. Biomed Instrum Technol, 2001, 34(6): 432-436.
28.	Bercik P, Schlageter V, Mauro M, et al. Noninvasive verification of nasogastric tube placement using a magnet-tracking system: a pilot study in healthy subjects. JPEN J Parenter Enteral Nutr, 2005, 29(4): 305-310.
29.	Kearns PJ, Donna C. A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique. JPEN J Parenter Enteral Nutr, 2001, 25(4): 210-215.
30.	Hernándezsocorro CR, Marin J, Ruizsantana S, et al. Bedside sonographic-guided <italic>versus</italic> blind nasoenteric feeding tube placement in critically ill patients. Crit Care Med, 1996, 24(10): 1690-1694.
31.	Brun PM, Chenaitia H, Bessereau J, et al. Contrôle échographique de la position de la sonde nasogastrique en préhospitalier. Ann Fr Anesth Reanim, 2012, 31(5): 416-420.
32.	Chenaitia H, Brun PM, Querellou E, et al. Ultrasound to confirm gastric tube placement in prehospital management. Resuscitation, 2012, 83(4): 447-451.
33.	冷英杰, 丁婷, 缪羽, 等. 超声辅助法置入经鼻空肠营养管在急性重症胰腺炎中的应用与护理. 东南国防医药, 2015, 17(5): 502-505.
34.	The Joanna Briggs Institute. 确定成人鼻胃管正确置管位置的方法. 中华护理杂志, 2013, 48(2): 190-192.
35.	Brun PM, Chenaitia H, Bessereau J, et al. Ultrasound evaluation of the nasogastric tube position in prehospital. Ann Fr Anesth Reanim, 2012, 31(5): 416-420.
36.	Kim HM, So BH, Jeong WJ, et al. The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center. Scand J Trauma Resusc Emerg Med, 2012, 20: 38.
37.	Lamont T, Cousins D, Hillson R, et al. Reliable administration of insulin: summary of a safety report by the British National Patient Safety Agency. Praxis, 2011, 100(6): 363-366.
38.	Fletcher J. Nutrition: safe practice in adult enteral tube feeding. Br J Nurs, 2011, 20(19): 1234, 1236-1239.
39.	Metheny N, Reed L, Berglund B, et al. Visual characteristics of aspirates from feeding tubes as a method for predicting tube location. Nurs Res, 1994, 43(5): 282-287.
40.	Metheny NA, Stewart BJ, Smith L, et al. PH and concentration of bilirubin in feeding tube aspirates as predictors of tube placement. Nuts Res, 1999, 48(4): 189-197.
41.	Joanna Briggs Institute. Methods for determining the correct nasogastric tube placement after insertion in adults. (2010-01-01)[2017-09-25]. http://www.g-i-n.net/library/health-topics-collection/guidelines/jbi-au/methods-for-determining-the-correct-nasogastric-tube-placement-after-insertion-in-adults-14-1.
42.	葛津津, 刘薇群, 汤培凤, 等. 鼻胃管位置判断方法的研究进展. 解放军护理杂志, 2015, 32(19): 37-39.
43.	王祎, 左泽兰. 胃管回抽物 pH 测定法用于小儿胃管定位的研究. 中华护理杂志, 2008, 43(9): 835-836.
44.	唐丽, 芮萍. 测量抽吸物 pH 值联合胆红素法定位鼻胃管位置的系统评价. 中国老年学杂志, 2015, 6(12): 3420-3421.
45.	刘从秀, 吴雪兰, 吴丽娟, 等. 确定胃管置人位置困难患者的综合判断措施. 护理学杂志: 综合版, 2013, (8): 46-48.
46.	陈瑞云. 胃管位置判断方法改良在临床胃管留置中的应用与分析. 中国医药指南, 2016, 14(25): 73-74.
47.	Proehl JA, Heaton K, Naccarato MK, et al. Emergency nursing resource: gastric tube placement verification. J Emerg Nurs, 2011, 37(4): 357-362.
48.	Stroud M, Duncan H, Nightingale J, et al. Guidelines for enteral feeding in adult hospital patients. Gut, 2003, 52(Suppl 7): vii1-vii12.
49.	Khair J. Guidelines for testing the placing of nasogastric tubes. Nurs Times, 2005, 101(20): 26-27.
50.	Bankhead R, Boullata J, Brantley S, et al. Enteral nutrition practice recommendations. JPEN J Parenter Enteral Nutr, 2009, 33(2): 122-167.
51.	Metheny N. Verification of feeding tube placement (blindly inserted). (2010-04-01)[2017-08-01]. http://www.slideserve. com/navid/verification-of-feeding-tube-placement.
52.	Pt CT. Nursing management of nasogastric tube feeding in adult patients. (2010-07-01)[2017-08-01]. http://www.moh.gov.sg/ content/dam/moh_web/HPP/Nurses_nursing/2010/nasogastric%20tube%20feeding%20-%20book.pdf.
53.	NPSA. Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants. (2011-03-10)[2017-08-01]. http://www.nrls.npsa.nhs.uk/alerts.

1. 蔡威. 欧洲肠外和肠内营养学会继续教育专用课本: 临床营养基础. 3 版. 上海: 复旦大学出版社, 2012: 216-217.
2. 李小寒, 尚少梅. 基础护理学. 3 版. 北京: 人民卫生出版社, 2007: 210-211.
3. Meyers M, Ghahremani GG. Complications of gastrointestinal intubation. New York: Iatrogenic Gastrointestinal Complications, 1981: 65-89.
4. Galloway DC, Grudis J. Inadvertent intracranial placement of a nasogastric tube through a basal skull fracture. South Med J, 1979, 72(2): 240-241.
5. Pillai JB, Vegas A, Brister S. Thoracic complications of nasogastric tube: review of safe practice. Interact Cardiovasc Thorac Surg, 2005, 4(5): 429-433.
6. Roka YB, Shrestha M, Puri PR, et al. Fatal inadvertent intracranial insertion of a nasogastric tube. Neurol India, 2010, 58(5): 802-804.
7. Ellett ML. What is known about methods of correctly placing gastric tubes in adults and children. Gastroenterol Nurs, 2005, 27(6): 253-259; quiz 260-261.
8. 彭爱珍, 刘施岚. 一例胃管置入误入气管无典型症状的临床分析. 健康必读: 中旬刊, 2013, 12(8): 673.
9. 郭军荣. 判断胃管在胃内的第四种方法. 医学信息: 下旬刊, 2013, 26(10): 574.
10. Metheny N, Mcsweeney M, Wehrle MA, et al. Effectiveness of the auscultatory method in predicting feeding tube location. Nurs Res, 1990, 39(5): 262-267.
11. Elpern EH, Killeen K, Talla E, et al. Capnometry and air insufflation for assessing initial placement of gastric tubes. Am J Crit Care, 2007, 16(6): 544-549; quiz 550.
12. Clinical rounds. Confirming correct placement of NG tubes. Nursing, 2006, 36(1): 33-35.
13. De Boer JC, Smit BJ, Mainous RO. Nasogastric tube position and intragastric air collection in a neonatal intensive care population. Adv Neonatal Care, 2009, 9(6): 293-298.
14. Chau JP, Lo SH, Thompson DR, et al. Use of end-tidal carbon dioxide detection to determine correct placement of nasogastric tube: a meta-analysis. Int J Nurs Stud, 2011, 48(4): 513-521.
15. D’souza CR, Kilam SA, D’souza U, et al. Pulmonary complications of feeding tubes: a new technique of insertion and monitoring malposition. Can J Surg, 1994, 37(5): 404-408.
16. Burns SM, Carpenter R, Truwit JD. Report on the development of a procedure to prevent placement of feeding tubes into the lungs using end-tidal CO<sub>2</sub> measurements. Crit Care Med, 2001, 29(5): 936-939.
17. Kindopp AS, Drover JW, Heyland DK. Capnography confirms correct feeding tube placement in intensive care unit patients. Can J Anaesth, 2001, 48(7): 705-710.
18. Thomas BW, Falcone RE. Confirmation of nasogastric tube placement by colorimetric indicator detection of carbon dioxide: a preliminary report. J Am Coll Nutr, 1998, 17(2): 195-197.
19. Araujo-Preza CE, Melhado ME, Gutierrez FJ, et al. Use of capnometry to verify feeding tube placement. Crit Care Med, 2002, 30(10): 2255-2259.
20. Howes DW, Shelley ES, Pickett W. Colorimetric carbon dioxide detector to determine accidental tracheal feeding tube placement. Can J Anaesth, 2005, 52(4): 428-432.
21. Meyer P, Henry M, Maury E, et al. Colorimetric capnography to ensure correct nasogastric tube position. J Crit Care, 2009, 24(2): 231-235.
22. 王瑞玉, 方梦明. 呼气末二氧化碳浓度监测下经气管导管导入胃管的体会. 护理学杂志, 1997, 12(6): 325.
23. 李燕, 高文斌, 陶喜民. 呼气末二氧化碳浓度监测在急置胃管中的应用. 中华急诊医学杂志, 2004, 13(4): 286.
24. 葛媚. 呼气末二氧化碳浓度监测在危重患儿急置胃管中的应用. 青海医药杂志, 2012, 42(7): 52-53.
25. Rulli F, Galatà G, Villa M, et al. A simple indicator of correct nasogastric suction tube placement in children and adults. Endoscopy, 2007, 39(Suppl 1): E237-E238.
26. Kearns PJ. Evaluation of diagnostic tests: verification of feeding tube placement using electromagnetic principles. Nutr Clin Pract, 1997, 12(1 Suppl): S61-S65; discussion S66.
27. Tobin RW, Gonzales AJ, Golden RN, et al. Magnetic detection to position human nasogastric tubes. Biomed Instrum Technol, 2001, 34(6): 432-436.
28. Bercik P, Schlageter V, Mauro M, et al. Noninvasive verification of nasogastric tube placement using a magnet-tracking system: a pilot study in healthy subjects. JPEN J Parenter Enteral Nutr, 2005, 29(4): 305-310.
29. Kearns PJ, Donna C. A controlled comparison of traditional feeding tube verification methods to a bedside, electromagnetic technique. JPEN J Parenter Enteral Nutr, 2001, 25(4): 210-215.
30. Hernándezsocorro CR, Marin J, Ruizsantana S, et al. Bedside sonographic-guided <italic>versus</italic> blind nasoenteric feeding tube placement in critically ill patients. Crit Care Med, 1996, 24(10): 1690-1694.
31. Brun PM, Chenaitia H, Bessereau J, et al. Contrôle échographique de la position de la sonde nasogastrique en préhospitalier. Ann Fr Anesth Reanim, 2012, 31(5): 416-420.
32. Chenaitia H, Brun PM, Querellou E, et al. Ultrasound to confirm gastric tube placement in prehospital management. Resuscitation, 2012, 83(4): 447-451.
33. 冷英杰, 丁婷, 缪羽, 等. 超声辅助法置入经鼻空肠营养管在急性重症胰腺炎中的应用与护理. 东南国防医药, 2015, 17(5): 502-505.
34. The Joanna Briggs Institute. 确定成人鼻胃管正确置管位置的方法. 中华护理杂志, 2013, 48(2): 190-192.
35. Brun PM, Chenaitia H, Bessereau J, et al. Ultrasound evaluation of the nasogastric tube position in prehospital. Ann Fr Anesth Reanim, 2012, 31(5): 416-420.
36. Kim HM, So BH, Jeong WJ, et al. The effectiveness of ultrasonography in verifying the placement of a nasogastric tube in patients with low consciousness at an emergency center. Scand J Trauma Resusc Emerg Med, 2012, 20: 38.
37. Lamont T, Cousins D, Hillson R, et al. Reliable administration of insulin: summary of a safety report by the British National Patient Safety Agency. Praxis, 2011, 100(6): 363-366.
38. Fletcher J. Nutrition: safe practice in adult enteral tube feeding. Br J Nurs, 2011, 20(19): 1234, 1236-1239.
39. Metheny N, Reed L, Berglund B, et al. Visual characteristics of aspirates from feeding tubes as a method for predicting tube location. Nurs Res, 1994, 43(5): 282-287.
40. Metheny NA, Stewart BJ, Smith L, et al. PH and concentration of bilirubin in feeding tube aspirates as predictors of tube placement. Nuts Res, 1999, 48(4): 189-197.
41. Joanna Briggs Institute. Methods for determining the correct nasogastric tube placement after insertion in adults. (2010-01-01)[2017-09-25]. http://www.g-i-n.net/library/health-topics-collection/guidelines/jbi-au/methods-for-determining-the-correct-nasogastric-tube-placement-after-insertion-in-adults-14-1.
42. 葛津津, 刘薇群, 汤培凤, 等. 鼻胃管位置判断方法的研究进展. 解放军护理杂志, 2015, 32(19): 37-39.
43. 王祎, 左泽兰. 胃管回抽物 pH 测定法用于小儿胃管定位的研究. 中华护理杂志, 2008, 43(9): 835-836.
44. 唐丽, 芮萍. 测量抽吸物 pH 值联合胆红素法定位鼻胃管位置的系统评价. 中国老年学杂志, 2015, 6(12): 3420-3421.
45. 刘从秀, 吴雪兰, 吴丽娟, 等. 确定胃管置人位置困难患者的综合判断措施. 护理学杂志: 综合版, 2013, (8): 46-48.
46. 陈瑞云. 胃管位置判断方法改良在临床胃管留置中的应用与分析. 中国医药指南, 2016, 14(25): 73-74.
47. Proehl JA, Heaton K, Naccarato MK, et al. Emergency nursing resource: gastric tube placement verification. J Emerg Nurs, 2011, 37(4): 357-362.
48. Stroud M, Duncan H, Nightingale J, et al. Guidelines for enteral feeding in adult hospital patients. Gut, 2003, 52(Suppl 7): vii1-vii12.
49. Khair J. Guidelines for testing the placing of nasogastric tubes. Nurs Times, 2005, 101(20): 26-27.
50. Bankhead R, Boullata J, Brantley S, et al. Enteral nutrition practice recommendations. JPEN J Parenter Enteral Nutr, 2009, 33(2): 122-167.
51. Metheny N. Verification of feeding tube placement (blindly inserted). (2010-04-01)[2017-08-01]. http://www.slideserve. com/navid/verification-of-feeding-tube-placement.
52. Pt CT. Nursing management of nasogastric tube feeding in adult patients. (2010-07-01)[2017-08-01]. http://www.moh.gov.sg/ content/dam/moh_web/HPP/Nurses_nursing/2010/nasogastric%20tube%20feeding%20-%20book.pdf.
53. NPSA. Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants. (2011-03-10)[2017-08-01]. http://www.nrls.npsa.nhs.uk/alerts.

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留置鼻胃管位置判断方法应用及研究现状

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