不同喂养状态及体位下注射器抽吸与超声测量胃残留量一致性评价

目的探讨不同喂养状态、不同体位使用50 mL注射器抽吸与超声测量胃残留量的一致性,为临床准确评估胃残留量提供参考。方法便利选取137例留置鼻胃管患者,分别在空腹(禁食8 h以上)、持续喂养后4 h、间断推注后4 h,在左侧位、仰卧位、右侧位下用注射器抽吸胃残留量,并与右侧位超声测量的标准胃残留量进行Bland-Altman一致性评价和回归分析。结果空腹时3种体位下注射器抽吸与超声测量胃残留量具有一致性,Bland-Altman分析示两种测量方法在3种体位下的差值均95%以上在一致性范围内;持续喂养和间断推注后4 h,右侧位下注射器抽吸与超声测量胃残留量具有一致性,两种方法的差值95%以上在一致性范围内。结论空腹时3种体位注射器抽吸与超声测量的胃残留量具有较高的一致性,而喂养过程中仅右侧位下注射器抽吸与超声测量结果有较高的一致性。

The consistency between syringe suction and ultrasound measurement of gastric residual volume at different positions and feeding patterns

Objective To evaluate the consistency between syringe suction using 50 mL injection syringe and ultrasound measurement of gastric residual volume (GRV) at different positions and feeding patterns, and to provide reference for accurate assessment of GRV. Methods A total of 137 patients with nasogastric tube were recruited to measure their GRV through syringe suction at three different positions including left lateral position, supine position and right lateral position at three different feeding patterns:fasting more than 8 hours, 4 hours after continuous feeding and 4 hours after intermittent feeding. At the same time, ultrasound measurement of GRV at right lateral position was also conducted as gold standard. Bland-Altman method and regression analysis were performed to determine the level of agreement. Results Bland-Altman method showed excellent agreement between syringe suction and ultrasound assessment at fasting pattern at all 3 positions,with 95% of the data points lying within the agreement interval (±1.96 s of the mean difference). Acceptable agreement of the two methods was also found at right lateral position during continuous feeding and intermittent feeding, with 95% of the data points lying within the agreement interval. Conclusion High consistency between syringe suction and ultrasound assessment of GRV was verified at all 3 different positions when patients were fasting more than 8 hours. However, consistency of the two methods during enteral feeding was only found at right lateral position.