Chen Yen-Chun, Wang Lien-Yen, Chang Yu-Jun, Yang Chao-Pin, Wu Tsung-Ju, Lin Fung-Ru, Liu Sen-Yung, Wei Ta-Sen
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
Department of Nuclear Medicine, Changhua Christian Hospital, Changhua, Taiwan.
PLoS One. 2014 Feb 10;9(2):e88046. doi: 10.1371/journal.pone.0088046. eCollection 2014.
Correct placement of nasogastric tubes provide proper functionality and maximize benefit and minimize risk. The Nose-Ear-Xiphoid (NEX) body surface estimate method is a long-lasting technique, and this study was conducted to evaluate the correlation between NEX method and the secure insertion depth of nasogastric tube.
Thirty patients with nasogastric tube insertion who received whole body positron emission tomography with computerized tomography scan (PET-CT) were recruited. All data were gathered in the image center, which included Nose-Ear (NE), Ear-Xiphoid (EX), Nose-Ear-Xiphoid (NEX), glabella-xiphoid (GX) and glabella-umbilicus (GU) lengths. The distances of the inserted portion of the nasogastric tube between the cardiac and the nostril were measured by multiplanar reconstruction algorithm.
Only one patient successfully placed all side-holes into the stomach while using NEX method to estimate inserting depth. Twenty-nine patients (96.7%) failed to place correctly. Fourteen participants had one or more side-holes in both the esophagus and the stomach sides. Fifteen patients could not pass through any side-hole across the gastroesophageal junction. They had shorter EX distances (p = 0.02), but no difference among the NE distances. Body height had the highest statistical correlation with nasogastric tube length (adjusted R(2) = 0.459), as compared with the NEX, GX and GU body surface methods.
This study suggests that NEX method is inappropriate for adult patients to estimate the ideal inserting length of nasogastric tube. Physicians should realize these underinsertions with any side-hole above the gastroesophageal junctions may increase the potential risk of complications.
鼻胃管的正确放置可确保其正常功能，使益处最大化并将风险降至最低。鼻-耳-剑突（NEX）体表预估方法是一种长期使用的技术，本研究旨在评估NEX方法与鼻胃管安全插入深度之间的相关性。
招募了30例接受全身正电子发射断层扫描与计算机断层扫描（PET-CT）的鼻胃管插入患者。所有数据均在影像中心收集，包括鼻-耳（NE）、耳-剑突（EX）、鼻-耳-剑突（NEX）、眉间-剑突（GX）和眉间-脐（GU）长度。通过多平面重建算法测量鼻胃管插入部分在心脏与鼻孔之间的距离。
在使用NEX方法预估插入深度时，仅1例患者成功将所有侧孔置于胃内。29例患者（96.7%）放置错误。14名参与者在食管和胃侧均有一个或多个侧孔。15例患者无法使任何侧孔穿过胃食管交界处。他们的EX距离较短（p = 0.02），但NE距离无差异。与NEX、GX和GU体表方法相比，身高与鼻胃管长度的统计相关性最高（调整后R² = 0.459）。
本研究表明，NEX方法不适用于成年患者预估鼻胃管的理想插入长度。医生应认识到胃食管交界处上方任何侧孔未完全插入可能会增加并发症的潜在风险。
