Inkqubo ye-metabolic yomzimba womntu yinkqubo yebhayoloji ye-oxidation, kwaye ioksijini efunekayo kwinkqubo ye-metabolic ingena egazini lomntu ngenkqubo yokuphefumla, idibanisa ne-hemoglobin (Hb) kwiiseli zegazi ezibomvu ukwenza i-oxyhemoglobin (HbO2), emva koko. ihambisa kuwo onke amalungu omzimba.Inxalenye yeeseli zethishu iyahamba.
Ukugcwala kweoksijini yegazi (SO2)yipesenti yomthamo we-oxyhemoglobin (HbO2) eboshwe yi-oksijini egazini ukuya kumthamo opheleleyo we-hemoglobin (Hb) onokubotshwa, oko kukuthi, ukuxinwa kwe-oksijini yegazi egazini.I-physiology ebalulekileyo yeparameter yomjikelezo wokuphefumula.I-oxygen saturation esebenzayo ngumlinganiselo we-HbO2 yoxinaniso kwi-HbO2 + Hb yoxinaniso, eyahlukileyo kwipesenti ye-hemoglobin ene-oxygen.Ngoko ke, ukubeka iliso kwi-arterial oxygen saturation (SaO2) inokuqikelela i-oksijini yemiphunga kunye nokukwazi kwe-hemoglobin ukuthwala i-oksijini.Ukuzaliswa kwe-oksijini yegazi eqhelekileyo kwi-arterial yomntu yi-98%, kwaye igazi le-venous yi-75%.
(I-Hb imele i-hemoglobin, i-hemoglobin, i-Hb efinyeziweyo)
Iindlela zokulinganisa
Izifo ezininzi zeklinikhi ziya kubangela ukungabikho kweoksijini, eya kuchaphazela ngokuthe ngqo imetabolism eqhelekileyo yeeseli, kwaye isongele ubomi bomntu.Ke ngoko, ukujongwa kwexesha lokwenyani loxinzelelo lwe-oxygen yegazi kubaluleke kakhulu ekuhlangulweni kweklinikhi.
Indlela yokulinganisa i-oksijini yesiqhelo yegazi kukuqokelela igazi kuqala emzimbeni womntu, kwaye emva koko usebenzise isihlalutyi segesi yegazi kuhlalutyo lwe-electrochemical ukulinganisa uxinzelelo olungaphelelangaigazi oksijini PO2ukubala ukugcwala kweoksijini egazini.Le ndlela inzima kwaye ayikwazi ukubeka iliso ngokuqhubekayo.
Indlela yangoku yokulinganisa kukusebenzisa aumnwe umkhono photoelectric sensor.Xa ulinganisa, kufuneka ubeke inzwa emnweni womntu, usebenzise umnwe njengesitya esicacileyo se-hemoglobin, kwaye usebenzise isibane esibomvu esine-wavelength ye-660 nm kunye nokukhanya okukufutshane kwe-infrared kunye nobude be-940 nm njengemitha.Ngenisa umthombo wokukhanya kwaye ulinganise ubunzulu bokuhanjiswa kokukhanya ngebhedi yethishu ukubala ugxininiso lwe-hemoglobin kunye nokugcwala kweoksijini yegazi.Isixhobo sinokubonisa i-oxygen saturation yegazi lomntu, ukubonelela ngesixhobo esiqhubekayo sokulinganisa i-oksijini yegazi kwikliniki.
Ixabiso lereferensi kunye nentsingiselo
Ngokuqhelekileyo kukholelwa ukubaSpO2akufunekanga ibe ngaphantsi kwe-94% ngokuqhelekileyo, kwaye ngaphantsi kwe-94% ayinayo i-oksijini eyaneleyo.Abanye abaphengululi babeka i-SpO2 <90% njengomgangatho we-hypoxemia, kwaye bakholelwa ukuba xa i-SpO2 iphezulu kune-70%, ukuchaneka kunokufikelela ku-± 2%, kwaye xa i-SpO2 iphantsi kwe-70%, kunokubakho iimpazamo.Kwinkqubo yeklinikhi, siye sathelekisa ixabiso le-SpO2 lezigulane ezininzi ezinexabiso le-arterial blood saturation value.Sikholelwa ukubaUkufundwa kwe-SpO2inokubonakalisa umsebenzi wokuphefumula wesigulane kwaye ibonise utshintsho lwe-arterialigazi oksijiniukusa kumlinganiselo othile.Emva kokuhlinzwa kwe-thoracic, ngaphandle kweemeko zomntu ngamnye apho iimpawu zekliniki kunye nemilinganiselo ayihambelani, uhlalutyo lwegesi yegazi luyafuneka.Ukusetyenziswa kwesiqhelo kwe-pulse oximetry monitoring kunokubonelela ngezalathisi ezinentsingiselo zokuqwalaselwa kweklinikhi utshintsho kwisifo, ukuphepha isampuli yegazi ngokuphindaphindiweyo kwizigulane kunye nokunciphisa abongikazi 'Umthwalo womsebenzi ufanelekile ukukhuthaza.Ngokweklinikhi, ngokubanzi ngaphezu kwe-90%.Kakade ke, kufuneka ibe kumasebe ahlukeneyo.
Isigwebo, umonakalo, kunye nokulahlwa kwe-hypoxia
I-Hypoxia kukungalingani phakathi kokunikezelwa kweoksijini yomzimba kunye nokusetyenziswa kweoksijini, oko kukuthi, i-tissue cell metabolism ikwimo ye-hypoxia.Ingaba umzimba u-hypoxic okanye awuxhomekeke ekubeni ubungakanani bokuthuthwa kwe-oksijini kunye nokugcinwa kwe-oksijini efunyenwe yi-tissue nganye inokuhlangabezana neemfuno ze-aerobic metabolism.Umonakalo we-hypoxia unxulumene neqondo, izinga kunye nobude be-hypoxia.I-hypoxemia enzima yimbangela eqhelekileyo yokufa kwi-anesthesia, ibalwa malunga ne-1/3 ukuya kwi-2/3 yokufa ngenxa yokubanjelwa kwentliziyo okanye umonakalo omkhulu weseli yengqondo.
Ngokonyango, nayiphi na i-PaO2 <80mmHg ithetha i-hypoxia, kwaye <60mmHg ithetha i-hypoxemia.I-PaO2 yi-50-60mmHg ebizwa ngokuba yi-mild hypoxemia;I-PaO2 yi-30-49mmHg ebizwa ngokuba yi-hypoxemia ephakathi;I-PaO2 <30mmHg ibizwa ngokuba yi-hypoxemia enzima.I-oksijeni yegazi yesigulane phantsi kokuphefumula kwamathambo, i-cannula ye-nasal kunye ne-mask oxygenation yayingu-64-68% kuphela (malunga ne-PaO2 30mmHg), eyona nto yayilingana ne-hypoxemia enzima.
I-Hypoxia inempembelelo enkulu emzimbeni.Njengempembelelo kwi-CNS, isibindi kunye nokusebenza kwezintso.Into yokuqala eyenzekayo kwi-hypoxia kukuhlawulela ukukhawuleza kwesantya sentliziyo, ukunyuka kwentliziyo kunye nokuphuma kwentliziyo, kunye nenkqubo yokujikeleza kwegazi ihlawulela ukungabikho komxholo we-oksijini kunye nombuso ophezulu onamandla.Ngelo xesha, ukwabiwa kwakhona kwegazi kwenzeka, kwaye ingqondo kunye nemithambo yegazi ye-coronary iyandiswa ngokukhethiweyo ukuqinisekisa ukunikezelwa kwegazi okwaneleyo.Nangona kunjalo, kwiimeko ezinzima ze-hypoxic, ngenxa yokuqokelelwa kwe-subendocardial lactic acid, i-ATP synthesis iyancitshiswa, kwaye i-myocardial inhibition iyaveliswa, ekhokelela kwi-bradycardia, i-pre-contraction, uxinzelelo lwegazi kunye nokuphuma kwentliziyo, kunye ne-fibrillation ye-ventricular kunye nezinye i-arrhythmias. yeka.
Ukongeza, i-hypoxia kunye nesifo sesigulane sinokuba nefuthe elibalulekileyo kwi-homeostasis yesigulane.
Ixesha lokuposa: Oct-12-2020