Usoro metabolic nke ahụ mmadụ bụ usoro oxidation nke ndụ, na oxygen a chọrọ na usoro metabolic na-abanye n'ọbara mmadụ site na usoro iku ume, jikọtara ya na hemoglobin (Hb) na mkpụrụ ndụ ọbara uhie ka ọ ghọọ oxyhemoglobin (Hbo2), wee mepụta oxyhemoglobin (HbO2), wee mee ka ọ bụrụ oxyhemoglobin. na-ebuga ya n'akụkụ niile nke ahụ.Akụkụ nke mkpụrụ ndụ anụ ahụ na-aga.
Ọbara oxygen saturation (SO2)bụ pasentị nke olu oxyhemoglobin (HbO2) nke ikuku oxygen dị n'ọbara jikọtara ya na mkpokọta hemoglobin (Hb) nke enwere ike ijikọ, ya bụ, ntinye oxygen nke ọbara n'ime ọbara.Ọ bụ ihe dị mkpa physiology nke usoro iku ume okirikiri.Saturation oxygen na-arụ ọrụ bụ nha nke ntinye uche HbO2 na ntinye uche HbO2+Hb, nke dị iche na pasenti nke hemoglobin oxygenated.Ya mere, nlekota ikuku oxygen saturation (SaO2) nwere ike ịkọwa oxygenation nke ngụgụ na ike hemoglobin na-ebu oxygen.Nkịtị oxygen saturation nke akwara ọbara mmadụ bụ 98%, yana ọbara venous bụ 75%.
(Hb na-anọchi anya hemoglobin, hemoglobin, abbreviated Hb)
Ụzọ nha
Ọtụtụ ọrịa na-adakarị ọrịa ga-eme ka enweghị oxygen ọkọnọ, nke ga-emetụta kpọmkwem metabolism nkịtị nke mkpụrụ ndụ, na-egwu egwu ndụ mmadụ.Ya mere, nleba anya n'otu oge maka itinye uche oxygen na akwara akwara dị ezigbo mkpa na nnapụta ụlọ ọgwụ.
Usoro nleba anya saturation ọbara oxygen nke ọdịnala bụ ibu ụzọ nakọta ọbara n'ahụ mmadụ, wee were nyocha gas ọbara maka nyocha electrochemical iji tụọ nrụgide akụkụ nkeoxygen ọbara PO2iji gbakọọ ikuku oxygen saturation.Usoro a siri ike ma enweghị ike nyochaa ya mgbe niile.
Usoro nha ugbu a bụ iji amkpịsị aka aka aka fotoelectric sensọ.Mgbe ị na-atụ ihe, naanị ị ga-etinye ihe mmetụta na mkpịsị aka mmadụ, jiri mkpịsị aka ya dị ka akpa transperent maka hemoglobin, ma jiri ọkụ na-acha uhie uhie nwere ogologo ogologo nke 660 nm na ọkụ infrared dị nso na ogologo nke 940 nm dị ka radieshon.Banye n'isi ọkụ wee tụọ ike nnyefe ọkụ site na akwa anụ ahụ iji gbakọọ mkpokọta hemoglobin na saturation oxygen n'ọbara.Ngwá ọrụ ahụ nwere ike igosipụta saturation oxygen nke ọbara mmadụ, na-enye ngwá ọrụ nha oxygen na-adịghị emetụta ọbara maka ụlọ ọgwụ.
Uru ntụaka na ihe ọ pụtara
A na-ekwenyekarị naSpO2ekwesịghị ịbụ ihe na-erughị 94% nkịtị, na ihe na-erughị 94% bụ ezughị oke oxygen.Ụfọdụ ndị ọkà mmụta setịpụrụ SpO2<90% dị ka ọkọlọtọ nke hypoxemia, ma kwenyere na mgbe SpO2 dị elu karịa 70%, izi ezi nwere ike iru ± 2%, na mgbe SpO2 dị ala karịa 70%, enwere ike inwe njehie.Na omume ụlọ ọgwụ, anyị atụnyere uru SpO2 nke ọtụtụ ndị ọrịa nwere uru ikuku oxygen saturation nke akwara akwara.Anyị kwenyere naỌgụgụ SpO2nwere ike igosipụta ọrụ iku ume nke onye ọrịa ma gosipụta mgbanwe nke akwaraoxygen ọbararuo n'ókè ụfọdụ.Mgbe ịwa ahụ thoracic, ma e wezụga maka ikpe onye ọ bụla ebe mgbaàmà ụlọ ọgwụ na ụkpụrụ adịghị adaba, a chọrọ nyocha ọbara ọbara.Ngwa nke nlekota oximetry pulse a na-eme kwa oge nwere ike inye ihe ngosi bara uru maka nyocha ụlọ ọgwụ nke mgbanwe ọrịa ahụ, na-ezere nlele ọbara ugboro ugboro maka ndị ọrịa na ibelata ndị nọọsụ 'Oru ọrụ kwesịrị ịkwalite.N'ụlọ ọgwụ, ọ na-adịkarị karịa 90%.N'ezie, ọ kwesịrị ịdị na ngalaba dị iche iche.
Ikpe, mmerụ ahụ, na mkpofu hypoxia
Hypoxia bụ ahaghị nhata n'etiti ikuku oxygen nke anụ ahụ na oriri oxygen, ya bụ, metabolism cell cell nọ n'ọnọdụ hypoxia.Ma ahụ ọ̀ bụ hypoxic ma ọ bụ na ọ bụghị na-adabere ma ọnụ ọgụgụ ikuku oxygen na ihe nchekwa oxygen nke anụ ahụ ọ bụla natara nwere ike gboo mkpa nke metabolism aerobic.Mmebi nke hypoxia metụtara ogo, ọnụego na ogologo oge nke hypoxia.Ọrịa hypoxemia siri ike bụ ihe na-akpatakarị ọnwụ site na nkụnwụ, na-aza ihe dịka 1/3 ruo 2/3 nke ọnwụ site na njide obi ma ọ bụ mmebi ụbụrụ ụbụrụ siri ike.
N'ụlọ ọgwụ, PaO2 <80mmHg ọ bụla pụtara hypoxia, na <60mmHg pụtara hypoxemia.PaO2 bụ 50-60mmHg nke a na-akpọ hypoxemia dị nro;PaO2 bụ 30-49mmHg nke a na-akpọ hypoxemia na-agafeghị oke;PaO2<30mmHg ka a na-akpọ hypoxemia siri ike.Ọbara oxygen saturation nke onye ọrịa n'okpuru iku ume orthopedic, cannula imi na ikuku oxygenation bụ naanị 64-68% (ihe dị ka PaO2 30mmHg), nke dabara na hypoxemia siri ike.
Hypoxia nwere mmetụta dị ukwuu na ahụ.Dị ka mmetụta na CNS, imeju na ọrụ akụrụ.Ihe mbụ na-eme na hypoxia bụ nkwụghachi ụgwọ nke ọnụọgụ obi, mmụba nke obi obi na mmepụta obi, na usoro ọbara na-akwụ ụgwọ maka enweghị ikuku oxygen na ọnọdụ dị elu.N'otu oge ahụ, mweghachi nke mgbaba ọbara na-eme, a na-ahọrọkwa ụbụrụ na arịa ọbara ọbara iji hụ na a na-enweta ọbara zuru oke.Otú ọ dị, n'ọnọdụ hypoxic siri ike, n'ihi nchịkọta nke subendocardial lactic acid, njikọ ATP na-ebelata, a na-emepụta mgbochi myocardial, nke na-eduga na bradycardia, pre-contraction, ọbara mgbali na mmepụta obi, yana fibrillation ventricular na ndị ọzọ arrhythmias ọbụna. Kwụsị.
Na mgbakwunye, hypoxia na ọrịa nke onye ọrịa nwere ike inwe mmetụta dị mkpa na homeostasis onye ọrịa.
Oge nzipu: Ọktoba 12-2020