Lavrsen M J, Tuxøe J I, Koch J S, Kirchhoff-Jensen R, Schulze S, Rosenberg J
H:S Hvidovre Hospital, ortopaedkirurgisk og kirurgisk gastroenterologisk afdeling.
Ugeskr Laeger. 1997 Feb 3;159(6):748-51.
The purpose of the study was to compare use of time with pulse oximetry versus arterial blood gas measurement on the general surgical ward. Eighty patients who had just had major orthopaedic or abdominal surgery were included in the study at two hospitals in Copenhagen. Success rate for pulse oximetry was 100% but only 89% for arterial blood gas measurement, because the laboratory did not analyse samples where the ice surrounding the syringe had melted when arriving at the laboratory or if there were air bubbles in the blood sample. At Hvidovre Hospital the results from the blood gas analysis were delayed median 58 minutes compared with 32 minutes at Sundby Hospital (p < 0.001). The delay at Hvidovre Hospital was largely due to prolonged time for transportation of the sample from the surgical ward to the laboratory by the hospital porter. No patient had hypercapnia or acid-base disturbances requiring treatment. With pulse oximetry reliable monitoring of arterial oxygenation can be obtained non-invasively and with a high success rate. Furthermore, the results are available for the clinician immediately compared with arterial blood gas measurement, where there is a delay in getting the results. We recommend that all general surgical wards should have a portable pulse oximeter for monitoring arterial oxygenation after major surgery.
本研究的目的是比较普通外科病房中使用脉搏血氧饱和度测定法与动脉血气测量法的时间情况。哥本哈根的两家医院纳入了80例刚接受大型骨科或腹部手术的患者进行研究。脉搏血氧饱和度测定法的成功率为100%,而动脉血气测量法仅为89%,原因是实验室不分析那些到达实验室时注射器周围的冰已融化的样本,或者血样中有气泡的样本。在维德夫勒医院,血气分析结果的延迟中位数为58分钟,而在桑德比医院为32分钟(p<0.001)。维德夫勒医院的延迟主要是由于医院搬运工将样本从外科病房运送到实验室的时间延长。没有患者出现需要治疗的高碳酸血症或酸碱紊乱。通过脉搏血氧饱和度测定法可以无创地获得可靠的动脉氧合监测,且成功率很高。此外,与动脉血气测量相比,结果可立即供临床医生使用,动脉血气测量获取结果存在延迟。我们建议所有普通外科病房都应配备便携式脉搏血氧仪,用于大手术后的动脉氧合监测。