局部氧饱和度监测在围术期的临床应用进展

Clinical application of local oxygen saturation monitoring in perioperative period

局部氧饱和度(rSO_2)是一种通过近红外光谱技术评估局部氧供需平衡的新型方法,具有无创、连续、灵敏等优点,已成功应用于临床指导。局部氧饱和度通常因监测部位不同而称为局部脑氧饱和度(rSCO_2)和局部组织氧饱和度(rStO_2)。最初,脑氧饱和度监测在心胸手术中得到应用,在老年和危重症患者的非心脏手术中也具有监测价值。随着临床运用增多,局部氧饱和度逐渐扩展到对外周组织氧饱和度的测定,用于评估外周组织微循环功能状态与患者预后之间的关系。及时发现组织缺血缺氧并予以干预可以优化整个临床治疗管理,尤其对重大手术及危重症患者可降低住院期间并发症发生率、缩短住院时间、改善患者预后。本文将着重介绍脑氧饱和度及组织氧饱和度在围术期的临床应用进展。

Regional oxygen saturation(rSO2) is a new method to evaluate regional oxygen supply and demand balance by near-infrared spectroscopy. It has the advantages of noninvasive, continuous and sensitive, and has been successfully applied in clinical guidance.Regional oxygen saturation is usually referred to as regional cerebral oxygen saturation(rScO2) and regional tissue oxygen saturation(rStO) depending on the site of monitoring. Initially, cerebral oxygen saturation monitoring has been used in cardiothoracic surgery and in non-cardiac surgery for elderly and critically ill patients. With the increase of clinical application, regional oxygen saturation is gradually extended to the determination of oxygen saturation in peripheral tissues, which is used to evaluate the relationship between peripheral tissue microcirculation function and the prognosis of patients. Timely detection of tissue ischemia and hypoxia and intervention can optimize the whole clinical treatment management, especially for major surgery and critically ill patients can reduce the incidence of complications during hospitalization, shorten hospitalization time, improve the prognosis of patients. This article will focus on the clinical application of cerebral oxygen saturation and tissue oxygen saturation in perioperative period.