【 key words 】 the blood oxygen saturation

Previous clinical observation method is not easy to identify early hypoxia, the application of pulse oxygen saturation (SpO2) monitor continuous noninvasive monitoring, can continuous dynamically observe the body oxygenation, timely find early hypoxemia, and to provide basis for clinical rescue and care, and at the same time, can avoid for many times to patients in arterial blood caused pain, reduce the workload of the nurse.
1 pulse oxygen saturation monitoring principle
SpO2 measurement is to probe fingertip fixed in patients with finger tip nail bed, using fingers as dress hemoglobin transparent container, the use of wavelength of 660 nm red and 940 nm near infrared scored as light source, determination through the organization of the bed light transmission intensity, to calculate the hemoglobin concentration and blood oxygen saturation. Can be applied to various patients blood oxygen monitoring. General think SpO2 normal shall not be lower than 94%, below 94% for lack of oxygen. Some scholars will SpO2 < 90% as the standard of hypoxemia.
2 pulse oxygen saturation monitoring method
Ecg monitor besides can monitoring SpO2 outside, still can also monitor the body temperature, respiration, noninvasive blood pressure and ecg/heart rate. The postoperative patients are at the same time monitoring blood pressure and heart waves, monitoring time 48 ~ 72 h. Monitoring period such as the discovery of reading suddenly slumps, timely inspection probe is loose, every 4 h inspection probe place finger skin condition, pay attention to see if there is red, swollen, skin damage, and replace another finger detection.
3 pulse oxygen saturation monitoring in clinical application
According to the change of 3.1 SpO2 adjust oxygen concentration oxygen concentration of high and low, the size of the flow can directly or indirectly influence SpO2 reading. The patients in order to maintain enough SpO2, postoperative conventional oxygen 36 ~ 72 h, patients operation finish back to the room, we will oxygen flow rate adjustment to 4 ~ 5 l/min, suction oxygen concentration is 37% ~ 41%, 96% ~ 99% SpO2 as soon as possible, hours after SpO2 according to reading, adjust oxygen concentration, avoid the high oxygen concentration caused by oxygen toxicity, or low oxygen concentration caused by hypoxia. There are reports hypoxemia by patients when administering oxygen inhalation through nasal catheter, flow 2 ~ 4 L/min, oxygen time 30 min, can make SpO2 reading increased 3% ~ 4%.
According to the numerical control 3.2 SpO2 sputum suction time on the patients with thoracic surgery, for drainage tube stimulus and wound pain, dare not productive cough, sputum retention respiratory tract and influence pulmonary ventilation function, lead to hypoxia, such as sputum jam airway is can cause lung infection or atelectasis. All the cases, the conventional give ultrasonic atomization inhalation twice a day, sputum aspirator every 2 ~ 4 h 1 time, every 2 h keel over knock back one and encourage patients cough productive to remove respiratory secretions, promote lung complex zhang. A clinical history of smoking patients often of secretion of respiratory tract, so frequency sputum suction can aggravate the respiratory stimulating influence pulmonary ventilation, and makes the respiratory tract secretion retention. Application SpO2 monitoring, can timely and accurate grasp opportunity and sputum suction sputum suction duration, when SpO2 < 90%, sputum suction in time to keep respiratory tract unobstructed. Before and after the sputum suction are giving high-concentration oxygen, sputum aspiration that should pay attention to closely observe patients of heart rate, blood pressure and SpO2 change. Such as sputum suction SpO2 when dropped to 85% should suspend, wait for after SpO2 rebound continue to attract, avoid because of persistent sputum suction time is too long, and lead to hypoxemia. If in the sputum aspiration after high-concentration oxygen inhalation 10 min above, SpO2 still cannot restore to its original level, should check SpO2 monitor probe their positions, as well as whether patients with lung function change or sputum lower respiratory tract obstruction, such as ropy sputum is not easy to attract, can increase the number of ultrasonic atomization inhalation.
3.3 the early detection of complications application SpO2 monitoring, to observe the postoperative complications will play a positive role to the one cases of esophageal cancer radical surgery patients, postoperative 1 day afternoon, patients self inductance chest tightness, shortness of breath, SpO2 reading dropped to below 90%, check the chest tube drainage unobstructed, sputum suction and improve the concentration of oxygen treatment, reading still cannot picks up, immediately report to the doctor, consider to side pleural effusion, cause gas exchange caused by limited. That give bedside indwelling chest drainage tube, and joint water bottle closed drainage, allowing patients to turn the corner. The author has been clinically logarithmic patients SpO2 numerical and arterial blood oxygen saturation numerical comparison, think SpO2 reading can reflect the patient's respiratory function, and to a certain extent reflect the changes of arterial blood oxygen. Thoracic surgery postoperative patients in addition to the individual cases clinical symptoms and numerical discrepancy should do the blood gas analysis, the conventional application of pulse oxygen saturation monitoring, but for clinical observation condition changes provide meaningful index, to avoid the repeated in patients with blood, but also reduce the workload of the nurse, is worth popularizing.