目的 探讨重氮试验在盲插鼻肠管后末端位置判断的应用效果。方法 采用便利抽样法，选取2021年9月至2022年1月山东省某三级甲等医院重症监护病房（intensive care unit,ICU）进行盲插鼻肠管术的216名患者为研究对象。采用重氮试验、测pH值、观察回抽液性质三种方式预测鼻肠管末端位置，以X线摄片为判定的金标准，确认鼻肠管末端位置。比较重氮试验及其他两种方式预测的准确率、敏感度、特异度、阳性结果预测值（positive predictive value,PPV）、阴性结果预测值（negative predictive value,NPV）、阳性似然比（positive likelihood ratio,PLR）、阴性似然比（negative likelihood ratio,NLR）等指标。结果 pH值判断的敏感度为97.7%、NPV为84.0%、NLR为0.045；回抽液性质判断的特异度为82.9%、PPV为95.5%、PLR为4.912；重氮试验方式的准确率为92.6%、Kappa系数为0.755；受试者操作特征曲线下面积最大为0.870，95%CI（0.793，0.947）。结论 重氮试验判断盲插鼻肠管末端位置的准确率、一致性较好，具有较高的临床预测价值。

Objective To explore the effectiveness of the diazotization test for predicting the end position of blindly inserted nasoenteric tubes.Methods Convenience sampling method was employed to select 216 ICU patients who underwent blind insertion of nasoenteric tubes in the intensive care unit of a tertiary A hospital in Shandong Province from September 2021 to January 2022 as subjects.The terminal position of the nasoenteric tube was predicted by three methods:diazotization test,pH measurement,and observation of retracted fluid properties.The end position was confirmed by X-ray radiography as the gold standard of determination.The accuracy,sensitivity,specificity,PPV,NPV,PLR,and NLR of the diazotization test and other methods were compared.Results The sensitivity,NPV and NLR of the pH measurement were 97.7%,84.0% and 0.045,respectively.The specificity,PPV,and PLR of retracted fluid property observation were 82.9%,95.5%,and 4.912,respectively.The diazotization test had an accuracy of 92.6% and the Kappa coefficient was 0.755.The largest area under the receiver operating characteristic curve was 0.870,95%CI(0.793,0.947).Conclusions The diazotization test shows high accuracy and consistency in determining the terminal position of blindly inserted nasoenteric tubes,demonstrating huge clinical predictive value.

R472.9

山东省医务职工科技创新计划联合立项项目（SDYWZGKCJHLH202236）