ʻO ke kaʻina hana metabolic o ke kino o ke kanaka he kaʻina hana oxidation biological, a ʻo ka oxygen i koi ʻia i ke kaʻina metabolic e komo i ke koko o ke kanaka ma o ka ʻōnaehana hanu, hui pū me ka hemoglobin (Hb) i loko o nā ʻulaʻula ʻulaʻula e hana i ka oxyhemoglobin (HbO2), a laila lawe ia i na wahi a pau o ke kino.E hele ana kekahi hapa o nā ʻiʻo.
Koko o ka oxygen saturation (SO2)ʻo ia ka pākēneka o ka nui o ka oxyhemoglobin (HbO2) i hoʻopaʻa ʻia e ka oxygen i loko o ke koko i ka nui o ka hemoglobin (Hb) hiki ke hoʻopaʻa ʻia, ʻo ia hoʻi, ka ʻike o ka oxygen koko i loko o ke koko.He physiology koʻikoʻi ia o ke ʻano o ka pōʻai hanu.ʻO ka saturation oxygen hana ʻo ia ka ratio o ka HbO2 paʻa i ka HbO2 + Hb, ʻokoʻa ia mai ka pākēneka o ka hemoglobin oxygenated.No laila, ʻo ka nānā ʻana i ka arterial oxygen saturation (SaO2) hiki ke koho i ka oxygenation o nā māmā a me ka hiki o ka hemoglobin ke lawe i ka oxygen.ʻO ka maʻamau o ke koko koko o ke kanaka he 98%, a ʻo ke koko venous he 75%.
(ʻO ka Hb no ka hemoglobin, hemoglobin, i hoʻopau ʻia ʻo Hb)
Nā ʻano ana
ʻO ka nui o nā maʻi lapaʻau e hoʻokau i ka nele o ka hāʻawi ʻana i ka oxygen, e hoʻopilikia pono i ka metabolism maʻamau o nā cell, a hoʻoweliweli koʻikoʻi i ke ola kanaka.No laila, he mea koʻikoʻi ka nānā ʻana i ka manawa maoli o ke koko o ke koko o ka oxygen i ka hoʻopakele lapaʻau.
ʻO ke ʻano o ke ana ʻana o ka oxygen saturation koko maʻamau, ʻo ia ka hōʻiliʻili mua ʻana i ke koko mai ke kino o ke kanaka, a laila e hoʻohana i ka mea nānā kino kinoea koko no ka nānā ʻana electrochemical e ana i ke kaomi ʻāpana o ke kino.koko oxygen PO2e helu i ka saturation oxygen koko.He paʻakikī kēia ʻano hana a ʻaʻole hiki ke nānā mau ʻia.
ʻO ke ʻano ana o kēia manawa ʻo ka hoʻohana ʻana i amīkini lima lima lima.I ke ana ana, pono wale oe e kau i ka mea ike ma ka manamana lima kanaka, e hoohana i ka manamanalima e like me ka ipu malamalama no ka hemoglobin, a e hoohana i ke kukui ulaula me ka nalu o 660 nm a me ke kukui infrared kokoke me 940 nm ka hawewe.E hoʻokomo i ke kumu kukui a ana i ka ikaika o ka lawe ʻana i ka māmā ma o ka moena kiko e helu ai i ka neʻe ʻana o ka hemoglobin a me ka saturation oxygen koko.Hiki i ka mea kani ke hōʻike i ka saturation oxygen koko o ke kanaka, e hāʻawi ana i kahi mea ana i ka oxygen koko non-invasive mau no ke keʻena.
Ka waiwai kuhikuhi a me ka manaʻo
Manaʻo nui ʻia kēlāSpO2ʻAʻole pono e emi ma lalo o 94% ma ke ʻano maʻamau, a ʻaʻole lawa ka hāʻawi oxygen ma lalo o 94%.Hoʻonohonoho kekahi poʻe akamai i ka SpO2<90% e like me ke kūlana o ka hypoxemia, a manaʻoʻiʻo i ka wā e kiʻekiʻe ai ka SpO2 ma mua o 70%, hiki i ka pololei ke hiki i ± 2%, a i ka wā SpO2 ma lalo o 70%, aia paha nā hewa.Ma ka hoʻomaʻamaʻa lapaʻau, ua hoʻohālikelike mākou i ka waiwai SpO2 o kekahi mau maʻi me ka waiwai saturation oxygen koko arterial.Manaʻo mākou ʻo kaHeluhelu SpO2hiki ke hōʻike i ka hana hanu o ka mea maʻi a hōʻike i ka loli o ke arterialkoko oxygeni kahi nui.Ma hope o ka ʻoki ʻana i ka ʻōpū, koe wale nō nā hihia pilikino kahi i kūlike ʻole nā hōʻailona lapaʻau a me nā waiwai, pono ke nānā ʻana i ke kinoea koko.ʻO ka hoʻohana maʻamau o ka nānā ʻana i ka pulse oximetry hiki ke hāʻawi i nā hōʻailona koʻikoʻi no ka nānā ʻana i nā loli o ka maʻi, e pale i ka hoʻomaʻamaʻa ʻana i ke koko no nā maʻi a me ka hōʻemi ʻana i nā kahu hānai.ʻO ke kino, ʻoi aku ma mua o 90%.ʻOiaʻiʻo, pono ia ma nā keʻena like ʻole.
ʻO ka hoʻoholo, ka pōʻino, a me ka hoʻokuʻu ʻana i ka hypoxia
ʻO ka Hypoxia kahi imbalance ma waena o ka hāʻawi ʻana i ka oxygen o ke kino a me ka hoʻohana ʻana i ka oxygen, ʻo ia hoʻi, ʻo ka metabolism cell tissue i loko o kahi kūlana hypoxia.ʻO ka hypoxic a ʻaʻole paha ke kino ma muli o ka nui o ka lawe ʻana o ka oxygen a me nā mālama oxygen i loaʻa i kēlā me kēia ʻiʻo hiki ke hoʻokō i nā pono o ka metabolism aerobic.ʻO ka pōʻino o ka hypoxia e pili ana i ke degere, ka nui a me ka lōʻihi o ka hypoxia.ʻO ka hypoxemia koʻikoʻi ke kumu maʻamau o ka make mai ka anesthesia, helu ʻia ma kahi o 1/3 a 2/3 o ka make ma muli o ka hopu ʻana o ka naʻau a i ʻole ka pōʻino o ka lolo.
Ma ke kino, ʻo kēlā me kēia PaO2<80mmHg ke ʻano o ka hypoxia, a ʻo ka <60mmHg ke ʻano o ka hypoxemia.ʻO PaO2 ka 50-60mmHg i kapa ʻia he hypoxemia haʻahaʻa;ʻO PaO2 ka 30-49mmHg i kapa ʻia ʻo moderate hypoxemia;Ua kapa ʻia ʻo PaO2<30mmHg he hypoxemia koʻikoʻi.ʻO ke koko oxygen saturation o ka mea maʻi ma lalo o ka hanu orthopedic, nasal cannula a me ka mask oxygenation he 64-68% wale nō (e like me ka PaO2 30mmHg), ʻo ia ka mea e like me ka hypoxemia koʻikoʻi.
He hopena nui ka Hypoxia i ke kino.E like me ka hopena i ka CNS, ka ate a me ka hana kīkī.ʻO ka mea mua i hana ʻia i ka hypoxia, ʻo ia ka compensatory acceleration o ka puʻuwai puʻuwai, ka piʻi ʻana o ka puʻuwai puʻuwai a me ka puka ʻana o ka naʻau, a ʻo ka ʻōnaehana circulatory e uku no ka nele o ka oxygen me kahi kūlana kiʻekiʻe.I ka manawa like, hiki mai ka hoʻokaʻawale ʻana o ke kahe koko, a hoʻonui ʻia ka lolo a me nā kīʻaha koko coronary e hōʻoia i ka lawa o ke koko.Eia nō naʻe, i nā kūlana hypoxic koʻikoʻi, ma muli o ka hōʻiliʻili ʻana o ka subendocardial lactic acid, hoʻemi ʻia ka ATP synthesis, a hana ʻia ka myocardial inhibition, e alakaʻi ana i ka bradycardia, pre-contraction, ke koko a me ka puʻuwai puʻuwai, a me ka ventricular fibrillation a me nā arrhythmias ʻē aʻe. kū.
Eia kekahi, hiki i ka hypoxia a me ka maʻi ponoʻī o ka mea maʻi ke hopena nui i ka homeostasis o ka mea maʻi.
Ka manawa hoʻouna: ʻOkakopa-12-2020