呼气末二氧化碳浓度测定法判断鼻胃管位置的系统评价

发布时间：2018-04-19 20:26

本文选题：二氧化碳 + 鼻胃管　；参考：《中华护理杂志》2016年03期

【摘要】：目的系统评价呼气末二氧化碳浓度测定法判断鼻胃管位置的准确性。方法计算机检索Cochrane图书馆、JBI循证护理中心图书馆、MEDLINE、EMbase、CINAHL、中国知网数据库、中国生物医学文献数据库、维普中文科技期刊全文数据库,收集所有关于呼气末二氧化碳浓度测定法判断胃管位置的诊断性试验。由2名研究员按照纳入和排除标准筛选文献,评价纳入文献的质量,并提取资料,使用Meta Disc 1.4软件进行Meta分析,综合评价灵敏度、特异度、似然比、诊断优势比,并用Rev Man 5.0绘制森林图和SROC曲线。结果共检索文献256篇,最终纳入9项研究,共949例研究对象。Meta分析结果显示,呼气末二氧化碳浓度测定法判断胃管位置的合并敏感度为0.99(95%CI=0.98～0.99),合并特异度为0.93(95%CI=0.81～0.99),合并阳性似然比为9.05(95%CI=4.00～20.47),合并阴性似然比为0.01(95%CI=0.00～0.03),合并诊断优势比为581.47(95%CI=148.13～2282.48),SROC曲线下面积=0.96,Q=0.90。结论呼气末二氧化碳浓度测定法判断胃管位置敏感度和特异性均较高,与X线检测方法相比,具有操作方便、节约时间、利于早期喂养、成本低等优点,可作为重症监护室或意识障碍患者胃管位置的判断方法,但因其存在漏诊和误诊,因此,仍不能完全替代X线检测方法。
[Abstract]:Objective to evaluate systematically the accuracy of end-expiratory carbon dioxide concentration determination method in determining the position of nasogastric tube. Methods the Cochrane library was searched by computer, including MEDLINEN EMbase CINAHL, China knowledge Network Database, Chinese Biomedical Literature Database, Weipu Chinese Science and Technology Journal Full-text Database. All diagnostic tests were collected to determine the location of gastric tubes by end-expiratory carbon dioxide concentration measurement. According to the inclusion and exclusion criteria, two researchers sifted the literature, evaluated the quality of the included literature, extracted the data, and used Meta Disc 1.4 software for Meta analysis. The sensitivity, specificity, likelihood ratio and diagnostic odds ratio were comprehensively evaluated. Rev Man 5.0 was used to draw forest map and SROC curve. Results A total of 256 articles were retrieved, and 9 studies were included. The results of Meta-analysis showed that 949 subjects were included in the study. Conclusion the sensitivity and specificity of end-expiratory carbon dioxide concentration determination in determining gastric tube position are higher. Compared with X-ray detection method, it has the advantages of convenient operation, saving time, early feeding and low cost. It can be used as a method to judge the location of gastric tube in ICU or patients with consciousness disorder, but because of its misdiagnosis and missed diagnosis, it is still not a substitute for X-ray detection.
【作者单位】：复旦大学附属华东医院护理部;
【基金】：上海市护理学会立项课题(2014SD-B04) 复旦大学护理科研基金项目(FNF201301)
【分类号】：R472

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