可监测pH值的新型胃管在体外胃液pH值监测中的可靠性评价  

Reliability of a new gastric tube in monitoring pH in gastric juice ex vivo

作　　者：桑素娟 李丽楠 刘丽萍[2] 高娜[3] 程艳爽[2] SANG Sujuan;LI Li’nan;LIU Liping;GAO Na;CHENG Yanshuang(Chinese PLA Medical School,Beijing 100853,China;Department of Hepato-Pancreato-Biliary Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of General Surgery,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第一医学中心肝胆胰外科医学部,北京100853 [3]解放军总医院第一医学中心普通外科,北京100853

出　　处：《解放军医学院学报》2023年第7期794-799,共6页Academic Journal of Chinese PLA Medical School

基　　金：军队护理创新与培育专项计划(创新)(2021HL072)。

摘　　要：背景 胃液pH值的监测对预防应激性溃疡、评估抗酸治疗的疗效和预测鼻胃管位置具有重要意义,但常用的监测胃液pH值工具存在一定的局限性。可监测pH值的新型胃管(以下简称新型胃管)是本课题组最新研发的监测工具,可同时实现pH监测和鼻饲/胃肠减压功能。目的 体外实验评价新型胃管测量胃液pH值的可靠性。方法 收集2022年9-10月于解放军总医院第一医学中心肝胆外科和普通外科病区留置胃管的51例患者的214个胃液样本。分别使用新型胃管与实验室pH计对胃液样本进行测量。以实验室pH计测量的pH值作为基准,将胃液样本分为(pH≤4、40.05)。等效/非劣效检验结果:取等效界值为0.1(pH≤4区间)或0.2(其他区间或整个区间),经单侧检验,新型胃管测试结果 (pH值)均非劣或等效于实验室pH计测试结果 (P<0.025)。两种工具在不同分组中所测pH值的Pearson相关系数分别为0.901、0.851、0.564(P<0.001)。两种工具在各组中分别有4.76%(2/42)、2%(2/100)、2.78%(2/72)的点值在95%CI的一致限(LoAs)以外,所测pH值的差值的LoAs的95%CI的上下限均在临床容许范围内。结论 新型胃管与实验室pH计所测胃液pH值一致性好,尤其在酸性环境中。初步认为本课题组研发的可监测pH值的新型胃管在测量胃液pH值时有较高的准确性和可靠性。下一步我们将对该胃管进行调试后再进行进一步的体外和体内验证,以便更好地服务于临床。Background The monitoring of gastric pH value is of great significance in preventing stress ulcers,evaluating the efficacy of antacid therapy and predicting the position of nasogastric tube.However,the commonly used tools for monitoring gastric pH value have certain limitations.The new gastric tube that can monitor the pH value(hereinafter referred to as the new gastric tube)is the latest monitoring tool developed by our research group,which can realize the functions of pH monitoring and nasal feeding/gastrointestinal decompression at the same time.Objective To evaluate the reliability of the new gastric tube in measuring the pH value of gastric juice in vitro.Methods A total of 214 gastric juice samples were collected from 51 patients with indwelling gastric tubes in the Hepatobiliary Surgery and General Surgery Wards of the First Medical Center of Chinese PLA General Hospital from September to October in 2022.Gastric juice samples were measured using a new gastric tube and a laboratory pH meter,respectively.Taking the pH value measured by the laboratory pH meter as the benchmark,the gastric juice samples were divided into three groups with pH≤4,4<pH<7 and pH≥7.The reliability of the new gastric tube was evaluated by paired t-test,equivalence/non-inferiority test results of measurement data,Pearson correlation analysis and Bland-Altman consistency test.Results Difference test:According to different pH value intervals,the difference between the pH value of the gastric juice measured by the new gastric tube and the laboratory pH meter was compared(paired t test),and the results showed that there was no statistically significant difference in the pH value of each interval(P>>0.05).Equivalence/non-inferiority test results:Taking the equivalence boundary value as 0.1(pH≤4 interval)or 0.2(other intervals or the entire interval),after one-sided test,the new gastric tube test results(pH value)were not inferior or equivalent to laboratory pH meter test results(P<0.025).Pearson correlation coefficients of pH values

关 键 词：PH计 新型胃管 胃液PH值 一致性检验 胃液监测 

分 类 号：R651.15[医药卫生—外科学]