中华护理杂志 ›› 2025, Vol. 60 ›› Issue (14): 1700-1704.DOI: 10.3761/j.issn.0254-1769.2025.14.006

• 标准与规范 • 上一篇    下一篇

儿童胃管及肠管置管专家共识

国家儿童医学中心儿科护理联盟急危重症护理学组 国家儿童医学中心儿科护理联盟消化护理学组(执笔:邹瑜 顾莺 余卓文 黄艳 杨玉霞 李素云 王颖雯)()   

  1. 518038 深圳市儿童医院消化内科(邹瑜);复旦大学附属儿科医院护理部(顾莺,王颖雯),消化内科(余卓文),重症医学科(杨玉霞);南京儿童医院消化内科(黄艳);华中科技大学同济医学院附属协和医院护理部(李素云)
  • 收稿日期:2024-08-28 出版日期:2025-07-20 发布日期:2025-07-09
  • 作者简介:邹瑜:女,本科(硕士在读),副主任护师,护士长,E-mail:784142937@qq.com
  • 基金资助:
    国家重点研发计划(2021YFC2701800);上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22023240);深圳市“医疗卫生三名工程”项目(SZSM202311023)

Expert consensus on nasogastric tube and intestinal tube placement in children

Critical Care Group,Pediatric Nursing Alliance,National Children’s Medical Center;Gastroenterology Group,Pediatric Nursing Alliance,National Children’s Medical Center (Writing Committee:ZOU Yu,GU Ying,YU Zhuowen,HUANG Yan,YANG Yuxia,LI Suyun,WANG Yingwen)()   

  • Received:2024-08-28 Online:2025-07-20 Published:2025-07-09

摘要:

目的 形成儿童胃管及肠管置管专家共识(以下简称“共识”),为规范儿科临床医护人员实施儿童胃管及肠管置管操作提供参考。 方法 成立“共识”制订小组,根据证据资源金字塔模型5.0指导证据检索,全面回顾国内外儿童胃管及肠管置管的相关指南、专家共识、证据总结、系统评价和原始研究,形成“共识”初稿;通过1轮专家函询和1轮专家面对面会议,对条目内容进行调整和修改,形成“共识”终稿。 结果 专家函询问卷的有效回收率为100%,专家权威系数为0.891,肯德尔和谐系数为0.692(P<0.001);各条目适宜性评分的中位数为7~9分,一致性程度值<1.00。最终形成的“共识”包括置管人员资质要求、适应证及禁忌证、置管前评估、置管前准备、置管长度测量、置管要点、确认位置方法、冲管、固定与记录9个主题,47条推荐意见。 结论 该“共识”具有较强的科学性和实用性,内容覆盖儿童胃管及肠管置管过程的各个环节,为安全、规范实施儿童胃管及肠管置管提供参考与指导。

关键词: 胃管, 肠管, 置管, 儿童, 护理规范, 专家共识, 儿科护理学

Abstract:

Objective To form an expert consensus on nasogastric tube and intestinal tube placement in children (hereinafter referred to as the “consensus”),and provide a reference for pediatric medical workers regarding the operation of gastrointestinal tube placement in children. Methods A “consensus” formulation group was established. The “5.0” EBHC Pyramid Model was employed to systematically search,evaluate,summarize and extract relevant evidence to form the initial draft of the “consensus”. The RAND-UCLA expert consensus method was utilized. Through a round of expert inquiries by correspondence and a round of face-to-face expert discussions,the data were collated,analyzed,refined,and modified to form the final version of the “consensus”. Results The effective recovery rate of the expert inquiry questionnaire was 100%. The coefficient of expert authority(Cr) was 0.891. The Kendall’s concordance coefficient of the inquiries was 0.692(P<0.01),which was statistically significant. The median of the “RAND-UCLA” suitability score were 7-9 points,and the disagreement index(DI) value was<1.00. The final “consensus” encompasses 9 aspects,including qualification requirements for the tube placement personnel,indications and contraindications,preoperative assessment,preoperative preparation,measurement of tube length,key points of tube placement,methods for confirming the position,tube flushing,fixation,and recording,with 47 recommendations. Conclusion This “consensus” is scientific,rigorous,and practical,covering all links of the gastrointestinal tube placement process in children,providing reference and guidance for the safe and standardized implementation of gastrointestinal tube placement in children.

Key words: Nasogastric Tube, Intestinal Tube, Tube Insertion, Children, Nursing Procedure, Expert Consensus, Pediatric Nursing