以食管测压参数建立更精准的模型预测成人鼻胃管插入长度

Predicting the Insertion Length of Nasogastric Tubes:An Improved Model Based on Oesophageal Manometry for Adults

目的建立一种基于鼻-耳-剑突(NEX)测量成人鼻胃管(NGT)插入长度的预测模型,以提高置入的精准度。方法对广东省人民医院的患者进行了一个横断面研究(n=165)。首先对变量进行逐步回归筛选,使用分位数-分位数(QQ)图和残差图筛选异常值,采用残差标准差(RSE)、调整后的R平方和K倍交叉验证方法验证新模型的有效性。结果共有165名年龄在20岁至85岁之间接受食管测压(EM)的患者被分为这一队列。最终模型包括身高、发际线到剑突的距离(HX)和NEX的长度。排除5个异常值,并在表示鼻尖到食管下括约肌(NLES)距离的方程式中添加额外的插入长度15 cm,以预测NLES的长度。校正后的R2为0.78,模型的误差率为3.27%。此外,均方根误差(RMSE)为1.53,平均绝对误差(MAE)为1.26。最终方程式确定为“插入长度=0.14615×高度+0.00499×HX×NEX+25.48879”。结论综上所述,我们建立了一个包含变量身高、HX和NEX的回归模型来预测护理实践中成人NGTs插入长度。公式为插入长度=0.14615×高度+0.00499×HX×NEX+25.48879。在临床护理实践中,我们的公式可以帮助护士提高成人NGT插入的准确性和并发症的发生率。

Objective To develop a more accurate and predictive model to measure the length of nasogastric tube(NGT)insertion for adults based on the nose-ear-xiphisternum(NEX),improving the clinical nursing efficiency.Methods We conducted a cross-sectional study among patients in REDACTED(n=165).Stepwise regression was performed to filter variables.Quantile-quantile(QQ)plot and Residual plot were used to screen outliers.The residual standard error(RSE),adjusted R-squared(adjusted R2),and K-fold cross-validation methods were applied to verify the efficacy of the new model.Results A total of 165 patients aged 20-85 years who underwent oesophageal manometry(EM)were grouped in this cohort.Height,distance from the hairline to the xiphisternum(HX),and length of NEX were involved in the final model.Five outliers were excluded,and an extra insertion length of 15 cm was added to the equation representing the distance from the nose to the lower oesophageal sphincter(NLES)to predict the length of NLES.The adjusted R2 was 0.78,and the error rate of the model was 3.27%.In addition,the root mean square error(RMSE)was 1.53,and the mean absolute error(MAE)was 1.26.The final equation was determined as“insertion length=0.14615×height+0.00499×HX×NEX+25.48879”.Conclusion In conclusion,a regression model that comprises the variables height,HX,and NEX was developed to predict the adult insertion length of NGTs in nursing practice.The equation is insertion length=0.14615×height+0.00499×HX×NEX+25.48879.In clinical nursing practice,our equation can help nurses to improve the accuracy and the complications of NGT insertion for adults.