危重症患儿胃内 pH 值连续 pH 计监测与间断 pH 试纸监测的比较。

Comparison of continuous pH-meter and intermittent pH paper monitoring of gastric pH in critically ill children.

机构信息

Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Dr Castelo 47, Madrid, Spain.

出版信息

Eur J Gastroenterol Hepatol. 2012 Jan;24(1):33-6. doi: 10.1097/MEG.0b013e32834d4bac.

DOI:10.1097/MEG.0b013e32834d4bac

PMID:22016103

Abstract

OBJECTIVE

A gastric pH below 4 increases the risk of gastrointestinal hemorrhage in critically ill patients. The pH can be monitored intermittently by testing the gastric aspirate using pH paper or continuously using a pH-meter (often in combination with multichannel intraluminal impedance). The objective of this study was to compare these two methods of pH measurement.

METHODS

An observational, prospective study was conducted in critically ill children between 1 month and 14 years with at least two risk factors for gastrointestinal hemorrhage. Gastric pH was measured continuously by a multichannel pH-meter tube and every 2 h using pH paper on aspirates of gastric juice.

RESULTS

A total of 471 gastric pH measurements were analyzed. The mean gastric pH measured by the pH-meter was 4.3±2.5 and that by pH paper was 3.9±2.2. The gastric pH was above 4 in 49.6% of the measurements taken on the basis of the gastric aspirate and in 49.8% of the pH-meter readings. The correlation between the two methods was moderate (0.59; P<0.001) but the concordance was low (0.54). The concordance with regard to determining a gastric pH above or below 4 was 77%.

CONCLUSION

pH paper is a simple and inexpensive method that can be useful for initial patient monitoring, but it should not be used as a substitute for monitoring by pH-meter in patients in whom strict control of the gastric pH is required.

摘要

目的

胃 pH 值低于 4 会增加危重症患者胃肠道出血的风险。pH 值可以通过使用 pH 试纸间歇性地检测胃液抽吸物或使用 pH 计连续监测（通常与多通道腔内阻抗结合使用）来监测。本研究的目的是比较这两种 pH 测量方法。

方法

对 1 个月至 14 岁至少有两个胃肠道出血风险因素的危重症儿童进行了一项观察性、前瞻性研究。使用多通道 pH 计管连续测量胃 pH 值，并每 2 小时使用 pH 试纸测量胃液抽吸物的 pH 值。

结果

共分析了 471 次胃 pH 值测量值。pH 计测量的平均胃 pH 值为 4.3±2.5，pH 试纸测量的平均胃 pH 值为 3.9±2.2。根据胃液抽吸物，胃 pH 值大于 4 的测量值占 49.6%，pH 计读数的测量值占 49.8%。两种方法之间的相关性中等（0.59；P<0.001），但一致性较低（0.54）。确定胃 pH 值大于或小于 4 的一致性为 77%。