Morris R W, Buschman A, Warren D L, Philip J H, Raemer D B
Department of Anesthesia, Brigham and Women's Hospital, Boston, MA 02115.
J Clin Monit. 1988 Jan;4(1):16-20. doi: 10.1007/BF01618102.
Pulse oximetry was used to assess the prevalence of hypoxemia (arterial oxygen saturation of 90% or less) at various times in the immediate postoperative period: five minutes after arrival, 30 minutes later, and just before discharge. Among 149 inpatients studied, one or more hypoxemic measurements were made in 21 (14%) during their postoperative course. Of 92 outpatients, 1 (1%) was found to be hypoxemic. For inpatients, the prevalence of hypoxemia preoperatively, 5 minutes after arrival in recovery, 30 minutes later, and at discharge was 2%, 4%, 6%, and 9%, respectively. Patient factors associated with a significantly higher prevalence of hypoxemia were obesity (22%), body cavity surgical procedures (24%), age over 40 years (18%), American Society of Anesthesiologists physical status (I, 7%; II, 17%; III, 18%; IV, 100%), duration of anesthesia longer than 90 minutes (18%), and intraoperative administration of greater than 1,500 ml of fluid (20%). Unrecognized hypoxemia in postsurgical inpatients with or without these risk factors is common. Therefore routine monitoring of these patients with a pulse oximeter is suggested.
采用脉搏血氧饱和度测定法评估术后即刻不同时间点低氧血症（动脉血氧饱和度为90%或更低）的发生率：到达后5分钟、30分钟后以及出院前。在149例住院患者中，21例（14%）在术后病程中进行了一次或多次低氧血症测量。在92例门诊患者中，发现1例（1%）存在低氧血症。对于住院患者，术前、恢复室到达后5分钟、30分钟后以及出院时低氧血症的发生率分别为2%、4%、6%和9%。与低氧血症发生率显著较高相关的患者因素包括肥胖（22%）、体腔手术（24%）、年龄超过40岁（18%）、美国麻醉医师协会身体状况分级（I级，7%；II级，17%；III级，18%；IV级，100%）、麻醉持续时间超过90分钟（18%）以及术中补液量超过1500毫升（20%）。有或无这些危险因素的术后住院患者中未被识别的低氧血症很常见。因此，建议对这些患者常规使用脉搏血氧仪进行监测。
