Inzira ya metabolike yumubiri wumuntu ni inzira ya okiside ya biologiya, kandi ogisijeni ikenerwa mugikorwa cya metabolike yinjira mumaraso yumuntu binyuze mumyanya yubuhumekero, igahuza na hemoglobine (Hb) mumyanya mitsi itukura ikora oxyhemoglobine (HbO2), hanyuma hanyuma kuyitwara mu bice byose byumubiri.Igice c'utugingo ngengabuzima tujya.
Amaraso yuzuye ya ogisijeni (SO2)ni ijanisha ryubunini bwa oxyhemoglobine (HbO2) ihujwe na ogisijeni mu maraso kugeza ku mubare wuzuye wa hemoglobine (Hb) ushobora guhambirwa, ni ukuvuga kwibanda kwa ogisijeni mu maraso mu maraso.Nibintu byingenzi byimiterere yubuhumekero.Umwuzure wa ogisijeni ukora ni igipimo cyo kwibanda kwa HbO2 hamwe na HbO2 + Hb, bitandukanye nijanisha rya ogisijeni hemoglobine.Kubwibyo, gukurikirana ogisijeni yuzuye ya arterial (SaO2) irashobora kugereranya okisijeni yibihaha hamwe nubushobozi bwa hemoglobine bwo gutwara ogisijeni.Ubusanzwe amaraso ya arterial yumuntu yuzura ogisijeni ni 98%, naho amaraso yimitsi ni 75%.
(Hb bisobanura hemoglobine, hemoglobine, mu magambo ahinnye Hb)
Uburyo bwo gupima
Indwara nyinshi zamavuriro zizatera ikibazo cyo kubura ogisijeni, izagira ingaruka ku buryo busanzwe bwo guhinduranya ingirabuzimafatizo, kandi ibangamira ubuzima bwa muntu.Kubwibyo, kugenzura igihe nyacyo cyo gukwirakwiza amaraso ya ogisijeni ya arterial ni ngombwa cyane mugutabara kwa muganga.
Uburyo bwa gakondo bwo gupima umwuka wa ogisijeni ni ukubanza gukusanya amaraso mu mubiri w'umuntu, hanyuma ugakoresha isesengura rya gaze mu maraso mu gusesengura amashanyarazi kugirango bapime umuvuduko w'igice cyaogisijeni mu maraso PO2kubara amaraso ya ogisijeni yuzuye.Ubu buryo buragoye kandi ntibushobora gukomeza gukurikiranwa.
Uburyo bwo gupima ubu ni ugukoresha aurutoki rwintoki ifoto yumuriro.Iyo upimye, ugomba gusa gushyira sensor kurutoki rwumuntu, koresha urutoki nkigikoresho kibonerana cya hemoglobine, kandi ukoreshe itara ritukura rifite uburebure bwa 660 nm hamwe n’umucyo uri hafi ya infragre hamwe nuburebure bwa 940 nm nkimirasire.Injira isoko yumucyo hanyuma upime ubukana bwokwirakwiza urumuri unyuze muburiri bwa tissue kugirango ubare ubwinshi bwa hemoglobine hamwe nubwuzure bwa ogisijeni yamaraso.Igikoresho kirashobora kwerekana amaraso ya ogisijeni yamaraso yumuntu, gitanga ibikoresho bikomeza gupima ogisijeni yamaraso idahoraho.
Reba agaciro nubusobanuro
Muri rusange abantu bemeza koSpO2ntigomba kuba munsi ya 94% mubisanzwe, kandi ko munsi ya 94% idahagije ya ogisijeni.Intiti zimwe zashyizeho SpO2 <90% nkibipimo bya hypoxemia, kandi bemeza ko iyo SpO2 irenze 70%, ubunyangamugayo bushobora kugera kuri ± 2%, kandi iyo SpO2 iri munsi ya 70%, hashobora kubaho amakosa.Mubikorwa byubuvuzi, twagereranije agaciro ka SpO2 kubarwayi benshi bafite agaciro ka arterial maraso ogisijeni.Twizera koGusoma SpO2Irashobora kwerekana imikorere yubuhumekero yumurwayi kandi ikagaragaza ihinduka ryimitsiogisijeni mu marasoku rugero runaka.Nyuma yo kubagwa thoracic, usibye kubibazo byihariye aho ibimenyetso byamavuriro nindangagaciro bidahuye, birasabwa gusesengura gaze yamaraso.Gukoresha uburyo busanzwe bwo gukurikirana pulse oximetry birashobora gutanga ibimenyetso bifatika byo kureba amavuriro y’imihindagurikire y’indwara, kwirinda kwanduza amaraso inshuro nyinshi ku barwayi no kugabanya abaforomo 'Imirimo ikwiriye guteza imbere.Mubuvuzi, muri rusange birenze 90%.Birumvikana ko igomba kuba mu mashami atandukanye.
Urubanza, kwangiza, no guta hypoxia
Hypoxia ni ubusumbane hagati ya ogisijeni yumubiri hamwe nogukoresha ogisijeni, ni ukuvuga metabolisme selile selile iba muri hypoxia.Niba umubiri ari hypoxic cyangwa utarimo biterwa n’uko ubwinshi bwa transport ya ogisijeni hamwe n’ububiko bwa ogisijeni bwakiriwe na buri rugingo bishobora guhaza metabolism yo mu kirere.Ingaruka za hypoxia zijyanye nurwego, igipimo nigihe cya hypoxia.Hypoxemia ikabije nimpamvu ikunze guhitanwa na anesthesia, bingana na 1/3 kugeza 2/3 byurupfu rwatewe no gufatwa numutima cyangwa kwangirika kwubwonko bukabije.
Mubuvuzi, PaO2 <80mmHg isobanura hypoxia, naho <60mmHg bisobanura hypoxemia.PaO2 ni 50-60mmHg bita hypoxemia yoroheje;PaO2 ni 30-49mmHg bita hypoxemia iringaniye;PaO2 <30mmHg yitwa hypoxemia ikabije.Amaraso ya ogisijeni yuzuye yumurwayi mugihe cyo guhumeka kwa orthopedic, urumogi rwa mazuru hamwe na ogisijeni ya mask yari 64-68% gusa (hafi ya PaO2 30mmHg), ibyo bikaba byari bihwanye na hypoxemia ikabije.
Hypoxia igira ingaruka zikomeye kumubiri.Nkingaruka kuri CNS, umwijima nimpyiko.Ikintu cya mbere kibaho muri hypoxia ni umuvuduko wihuta w umuvuduko wumutima, kwiyongera k'umutima no gusohoka k'umutima, kandi sisitemu yo gutembera yishyura kubura ogisijeni ifite imbaraga nyinshi.Muri icyo gihe, isaranganya ry'amaraso rirabaho, kandi ubwonko n'imitsi y'amaraso byaraguwe neza kugira ngo hatangwe amaraso ahagije.Nyamara, mubihe bikabije bya hypoxique, kubera kwirundanya kwa acide lactique ya subendocardial, synthesis ya ATP iragabanuka, kandi hakorwa no kubuza myocardial, biganisha kuri bradycardia, mbere yo kwikuramo, umuvuduko wamaraso hamwe nibisohoka byumutima, hamwe na fibrillation ya ventricular na arththmias Ndetse hagarara.
Byongeye kandi, hypoxia n'indwara z'umurwayi zishobora kugira ingaruka zikomeye kuri homeostasis yumurwayi.
Igihe cyo kohereza: Ukwakira-12-2020