摘要
为评价超声检查胃管位置的可行性,选择2016年11月至2017年2月浙江省人民医院择期行气管插管全麻的开腹胃癌根治手术患者30例为研究对象,平均年龄（58±10）岁,BMI（21.8±2.8） kg/m^2,美国麻醉医师协会分级Ⅱ～Ⅲ级.患者入手术室后由手术室护士放置胃管,并行临床评估胃管位置,麻醉医生在气管插管时确定胃管进入食道,麻醉实施后由超声科医生和麻醉科医生分别采用胃部超声判断胃管位置.以术中外科医生确认胃管是否处于合适位置（胃管尖端位于胃体或胃窦部）为标准,进行Kappa一致性分析.与术中外科医生判断胃管位置相比,超声医生判断胃管位置的灵敏度为96％,特异度为80％,阳性预测值为96％,阴性预测值为50％,Kappa值为0.760（P＜0.01）;麻醉医生判断胃管位置的灵敏度为92％,特异度为40％,阳性预测值为92％,阴性预测值为60％,Kappa值为0.280 （P =0.125）;护士判断胃管位置的灵敏度为92％,特异度为0％,阳性预测值为100％,阴性预测值为71％,Kappa值为-0.105（P=0.513）.提示超声检查判断胃管位置效果较好,是一种简单、可靠和灵敏的方法.
Thirty patients with gastric cancer,ASA Ⅱ or Ⅲ,scheduled for selective radical gastrectomy under tracheal intubation general anesthesia in Zhejiang Provincial People＇s Hospital from November 2016 to February 2017 were enrolled in the study.The gastric tubes were placed by a nurse before operation.The position of gastric tube was judged under gastric ultrasonography by a sonographer and anesthesiologist respectively;and confirmed by the surgeon during the operation.With the position judged by the surgeon as gold standard,the sensitivity,specificity,positive predictive value,negative predictive value of the judgment of ultrasonographer were 96%,80%,96%,50%,respectively with the Kappa value 0.760 of （P 〈0.001）,those of the judgment of anesthesiologist were 92%,40%,92% and 60%,respectively with a Kappa value of 0.280 （P =0.125）;those of the judgment of nurse were 92%,0%,100% and 71.4%,with a Kappa value of-0.105 （P =0.513）.The results suggest that ultrasound examination is a simple,reliable and sensitive method for confirming correct gastric tube placement.
作者
周振锋
陈龙
於达
黄丽君
吴猛
胡双飞
Zhou Zhenfeng1, Chen Long1, Yu Da2, Huang Lijun2, Wu Meng3, Hu Shuangfei1(1 Department of Anesthesiology, Zhefiang Provincial People＇s Hospital ＆ People＇s Hospital of Hangzhou Medical College, Hangzhou 310009, China; 2Department of Anesthesiology, Yinzhou People＇s Hospital, Ningbo 315040, China ; 3Department of Ultrasonography, Yinzhou People＇s Hospital, Ningbo 315040, Chin)
出处
《中华全科医师杂志》
2018年第5期388-391,共4页
Chinese Journal of General Practitioners
基金
浙江省医药卫生一般研究计划B类项目（2013KYB244）
关键词
超声检查
胃
敏感性与特异性
Ultrasonography
Stomach
Sensitivity and specificity
