脉搏血氧饱和度监测在心血管疾病中的应用

目的探讨脉氧饱和度(SpO2)的变化与心肌梗死面积、心功能状况、合并阻塞性睡眠呼吸暂停综合征(OSAS)和肥胖低通气综合征以及病死率的关系。方法选择2003年10月至2006年6月鹤壁第一人民医院心内科220例心血管病患者,其中急性心肌梗死(AMI)患者149例,冠状动脉粥样硬化性心脏病心力衰竭40例,扩张型心肌病心力衰竭18例,风湿性心脏病心力衰竭13例。采用美国Hewlett-PackardCompany的OmnicareModel24型床边监护仪,用一光电传感器夹与患者食指相连接,连续监测脉搏血氧饱和度的变化。结果AMI病例中,SpO2>95%者100例,梗死面积皆较小,且无心力衰竭等严重并发症;SpO2在90%～95%者30例合并心力衰竭,且梗死面积较大。全组病例(220例)死亡11例,其中7例为大面积心肌梗死并心源性休克,2例为AMI合并OSAS,1例为冠状动脉粥样硬化性心脏病心力衰竭合并肥胖低通气综合征,1例为缺血性心肌病严重心力衰竭,SpO2均<85%。结论SpO2值越高,心肌梗死面积越小,合并症越少;SpO2越低,心肌梗死面积越大,合并症越多。SpO2值与心血管疾病病死率呈负相关(r=-0.64,P<0.05),SpO2<85%是心血管疾病预后不良的指标。

Application of Pulse Oxygen Saturation Monitoring in Cardiovascular Disease

Objective To observe the relationship among pulse oxygen saturation （ SpO2 ）, area size of acute myocardial infarction（AMI） ,cardiac function of heart diseases（ including AMI,diahed cardiomyopathy and rheumatic heart dise-ase） and the mortality rate of heart diseases mentioned above. Methods SpO2 were monitored continuously to 220 pati-ents with heart diseases admitted to our hospitals since October of 2003 to February of 2005,including 149 cases of AMI,40 cases of heart failure of coronary cardiac disease（ CAD）, 18 cases of heart failure of dialted cardiomyopathy（DCM） and 13 cases of heart failure of rheumatic heart disease（RHD）. The SpO2 monitor instruments was Omnicare Model 24 of Hewlett-Packard Company U. S. A. Results In AMI group,there were 100 cases whose SpO2 were above 95% only with a limited area size of myocardial infarction and without any serious complication such as heart failure, while all the 30 cases with the SpO2 between 90% - 95% had the extensive area size of myocardial infarction and obvi-ous cardiac insufficiency. All the dead patients of 11 cases had a SpO2 lower than 85% ,in which 7 cases were dead of c-ardiac shock of AMI,2 case were dead of the complication of the obstructive sleep apnea syndrom（OSAS） , 1 case of AMI was dead of the complication of Pickwickin syndrome, 1 case was dead of serious heart failure of ischemic car-diomyopathy. Conclusion The higher the Sp02, the limited the area size of AMI and the fewer the complications;the lower the SpO2 ,the extensive the area size of AMI and the more the complications; There was a obvious negative relati-onship between the SpO2 and mortality rate of heart diseases（ r =-0.64, P 〈0.05）,it means a serious prognosis if SpO2 lower than 85%.