【摘要】 目的:探讨床旁超声辅助鼻肠管置入法在急危重症患者中的临床应用价值。方法:选择2022年2月—2023年8月昆山市第一人民医院急诊重症监护病房及重症医学科需要放置空肠营养管的93例患者，利用床旁超声辅助鼻肠管置入，鼻肠管置入到位后利用床旁超声及腹部X线结合CT进行判断，以腹部X线结合CT判断作为“标准”,计算分析超声辅助鼻肠管置入法的灵敏度、特异度、阳性预测值、阴性预测值，同时利用Kappa分析法判断床旁超声辅助鼻肠管置入法与腹部X线或者CT判断法的一致性。结果:本研究93例患者中，经腹部X线或者CT确认空肠在位的72例，但有6例经超声判断不在位；经腹部X线或者CT确认空肠不在位的21例，而有5例经超声判断在位。床旁超声辅助鼻肠管置入法的灵敏度、特异度、阳性预测值、阴性预测值分别为91.67%、76.19%、92.96%、72.73%。床旁超声辅助鼻肠管置入法与腹部X线或者CT判断法两者的一致性分析：Kappa=0.667。结论:床旁超声辅助鼻肠管置入法快速简捷，与腹部X线或者CT判断有一定的相关性，有一定的临床应用价值。更多还原

【Abstract】 Objective: To investigate the clinical application value of bedside ultrasonic-assisted nasointestinal tube implantation in critical patients. Methods: A total of 93 patients requiring jejunal nutritional tube placement in the Emergency Intensive Care Unit(EICU) and the Department of Critical Care Medicine of the First People’s Hospital of Kunshan, were selected from February 2022 to August 2023, and bedside ultrasound-assisted nasoenteric tube placement was utilized, and bedside ultrasound and abdominal X-rays combined with CT were utilized to make judgments after the nasoenteric tubes were placed in place, and abdominal X-rays combined with CT judgments were used as the using abdominal X-ray and CT judgment as the “Gold standard”, we calculated and analyzed the sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound-assisted nasointestinal tube implantation. At the same time, Kappa analysis was used to determine the consistency between the bedside ultrasound-assisted nasointestinal tube implantation and abdominal X-ray or CT judgment. Results: In a total of 93 patients, 72 had the tube confirmed to be in the jejunum by abdominal X-ray or CT, but 6 were judged to be out of place by ultrasonography, 21 had the tube confirmed to be out of the jejunum by abdominal X-ray or CT, while 5 were judged to be in place by ultrasonography. The sensitivity, specificity, positive predictive value and invisible predictive value of bedside ultrasound-assisted nasoenterostomy were 91.67%,76.19%,92.96%,72.73%. The consistency analysis between bedside ultrasound-assisted nasointestinal tube implantation and abdominal X-ray or CT judgment: kappa=0.667. Conclusion: Bedside ultrasound-assisted nasointestinal tube implantation is fast and simple, and has a certain correlation with abdominal X-ray or CT judgment, which has some clinical value.更多还原