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<p style="padding-top: 7px;padding-bottom: 7px;word-wrap: break-word;word-break: break-all;color: rgb(51, 51, 51);font-family: 宋体;font-size: 14px;white-space: normal;background-color: rgb(255, 255, 255);"><span style="font-size: 15px;">脉搏血氧饱和度SpO2指的是血氧含量与血氧容量的百分比值。SpO2作为一种无创的、反应快速的、安全的、可靠的连续监测指标，已经得到公认。 目前在麻醉、手术以及PACU和ICU中得以广泛使用。根据氧合血红蛋白(HbO2)和还原血红蛋白(Hb)在红光和红外光区域的光谱特性，可知在红光区(600～700nm)HbO2和Hb的吸收差别很大，血液的光吸收程度和光散射程度极大地依赖于血氧饱和度；</span></p><p style="padding-top: 7px;padding-bottom: 7px;word-wrap: break-word;word-break: break-all;color: rgb(51, 51, 51);font-family: 宋体;font-size: 14px;white-space: normal;background-color: rgb(255, 255, 255);"><span style="font-size: 15px;">而在红外光谱区(800～1000nm)，则吸收差别较大，血液的光吸收程度和光散射程度主要与血红蛋白含量有关，所以，HbO2和Hb的含量不同吸收光谱也不同，因此血氧饱和度仪血液导管中的血无论是动脉血还是静脉血饱和度仪均能根据HbO2和Hb的含量准确地反映出血氧饱和度。</span></p><p style="padding-top: 7px;padding-bottom: 7px;word-wrap: break-word;word-break: break-all;color: rgb(51, 51, 51);font-family: 宋体;font-size: 14px;white-space: normal;background-color: rgb(255, 255, 255);"><span style="font-size: 15px;">血液在波长660nm附近和900nm附近反射之比(ρ660/900)最敏感地反映出血氧饱和度的变化，临床一般血氧饱和度仪(如泰嘉电子Taijia饱和度仪、脉搏血氧仪)也采用该比值作为变量。在光传导的途径上，除动脉血血红蛋白吸收光外，其他组织（如皮肤、软组织、静脉血和毛细血管血液）也可吸收光。但入射光经过手指或耳垂时，光可被搏动性血液和其他组织同时吸收，但两者吸收的光强度是不同的，搏动性动脉血吸收的光强度（AC）随着动脉压力波的变化而改变。</span></p><p style="padding-top: 7px;padding-bottom: 7px;word-wrap: break-word;word-break: break-all;color: rgb(51, 51, 51);font-family: 宋体;font-size: 14px;white-space: normal;background-color: rgb(255, 255, 255);"><span style="font-size: 15px;">而其他组织吸收的光强度（DC）不随搏动和时间而改变，由此，就可计算出在两个波长中的光吸收比率R。R=(AC660/DC660)/(AC940/DC940)。R与SpO2呈负相关，根据R值，由标准曲线可得出相应的SpO2值。 </span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"> <strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">一、血氧饱和度监测中的常见问题 ：</strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"> <strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">1、信号跟踪到脉搏，屏幕上无氧饱和度和脉率值。 </strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> 原因：</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （1）患者移动过度，过于躁动，使血氧饱和度参数找不到一个脉搏形式；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （2）患者可能灌注太低，如肢体温度过低、末梢循环太差，使氧饱和度参数不能测及血氧饱和度和脉率;</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （3）传感器损坏；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （4）传感器位置不准确（接头线应置手背，指甲面朝上）；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （5）血液中有染色剂（如美蓝、荧光素）、皮肤涂色或手指甲上涂有指甲油，也会影响测量精度；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="letter-spacing: 0.544px;"> （6）环境中有较强的光源。如手术灯、荧光灯或是其他光线直射时，会使探头的光敏元件的接受值偏离正常范围，因此需要避强光。必要时探头需遮光使用；</span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="letter-spacing: 0.544px;"> (7)探头戴的时间过长以后，可能影响血液循环，使测量精度受影响；</span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="letter-spacing: 0.544px;"> （8）另外，同侧手臂测血压时，会影响末梢循环而使测量值有误差。</span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">2、氧饱和度迅速变化，信号强度游走不定可能由于患者移动过度或由于手术装置干扰操作性能。</strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">3、氧饱和度显示传感器脱落 </strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （1）传感器如在位且性能良好，应注意连接是否正常，临床最常出现此种情况即液体溅进传感器接头处；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （2）血氧探头正常工作，开机自检后探头内发出较暗红光或红光较亮且闪烁不定。</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">二、血氧饱和度监测中常见问题的处理：</strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">1、信号跟踪到脉搏，屏幕上无氧饱和度和脉率值时的处理 </strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （1）密切观察患者病情；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （2）使患者保持不动或将传感器移到活动少的肢体，使传感器牢固适当或进行健康人测试，必要时更换传感器；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （3）必要时对所测患者注意保暖；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （4）需要避强光；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （5）时间过长可换另一手指测量；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> （6）尽量避免同侧手臂测血压。</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">2、氧饱和度迅速变化，信号强度游走不定时的处理尽量使患者保持安静少动，远离手术装置。</strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">3、氧饱和度显示传感器脱落时的处理 </strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;">（1）若液体溅进传感器接头处，可用干布清洁，待干或吹干一段时间后即可恢复正常工作；</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;">（2）当出现血氧探头正常工作，而开机自检后探头内发出较暗红光或红光较亮且闪烁不定。此时须更换电缆线。</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"><span style="max-width: 100%;color: rgb(112, 48, 160);box-sizing: border-box !important;word-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;">三、 SpO2报警值的设置 ： </strong></span></p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> SpO2正常值，吸空气时SpO2测得值≥95％～97％。</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> 低氧血症:SpO2＜95％者为去氧饱和血症，</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> SpO2＜90％为轻度低氧血症，</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> SpO2＜85％为重度低氧血症。</p><p style="margin-bottom: 10px;max-width: 100%;box-sizing: border-box;min-height: 1em;color: rgb(51, 51, 51);letter-spacing: 0.544px;text-align: left;white-space: normal;line-height: 25.6px;font-family: "Helvetica Neue", Helvetica, Arial, sans-serif;font-size: 16px;background-color: rgb(255, 255, 255);word-wrap: break-word !important;"> 一般报警低限的设置应高于90％</p><section class="" style="max-width: 100%;color: rgb(51, 51, 51);font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", " ingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;text-align: justify;white-space: normal;background-color: rgb(255, 255, 255);box-sizing: border-box !important;word-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><p style="max-width: 100%;min-height: 1em;box-sizing: border-box !important;word-wrap: break-word !important;"><img class=" " data-copyright="0" data-ratio="0.6100178890876565" data-s="300,640" data-type="png" data-w="559" width="auto" src="http://mmbiz.qpic.cn/mmbiz_png/A1DicCH9Vl6MK5Q8sxibcIbgTPECicmaSpkdc8Z9sZ08Rp4HCzAicktdjPgic7Q7trLRwDf6Z3zz8icJhxWHoCn4iaN0w/640?wx_fmt=png" style="box-sizing: border-box !important;word-wrap: break-word !important;visibility: visible !important;width: auto !important;" /></p></section></section><hr style="max-width: 100%;color: rgb(51, 51, 51);font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "ingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;text-align: justify;white-space: normal;background-color: rgb(255, 255, 255);box-sizing: border-box !important;word-wrap: break-word !important;" /><p style="margin-top: 10px;max-width: 100%;min-height: 1em;color: rgb(51, 51, 51);font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "ingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;font-size: 17px;letter-spacing: 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发表于 2020-10-21 12:24:52