国际麻醉学与复苏杂志   2013, Issue (10): 6-6
    
控制性缺氧条件下国产脉搏氧饱和度仪的准确度研究
李璐, 古妙宁, 肖金仿, 刘晓军, 张旖旎, 刘高望, 张雅婷, 解春艳1()
1.南方医科大学南方医院
The study of the accuracy of domestic pulse oximeter under controlled hypoxemia
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摘要:

目的 研究国产脉搏血氧饱和度仪(pulse oximeter, POM)在健康志愿者控制性缺氧条件下的准确度及特点,为临床安全、有效使用提供依据。 方法 通过吸入氧氮混合气体使健康志愿者处于缺氧状态,相同型号的POM采用Masimo和Nellcor两种脉氧探头同时监测脉搏血氧饱和度(pulse oxygen saturation, SpO2),监测SpO2区间为70%~100%,在>95%、92%、85%、78%、70%这5个目标值的区间内记录SpO2数值,并在相应时点抽动脉血行血气分析作对照。 结果 Masimo和Nellcor两种脉氧探头所测的70%~100%范围内的SpO2与血气分析所测的动脉血氧饱和度(arterial oxygen saturation, SaO2)相对照,差异都在标准范围内(Arms分别为2.16和2.32),Masimo探头的偏差(SpO2-SaO2)在≥80%和<80%时分别为0.93%和-1.45%,Nellcor探头则分别为0.16%和-1.91%,且两种探头差异有统计学意义(P<0.01)。 结论 使用Masimo和Nellcor探头的国产POM均能准确反映不同缺氧程度下的血氧饱和度情况,但两者由于原理的不同而存在差异,Nellcor探头读数普遍低于Masimo探头读数;随着SpO2读数下降,偏差朝着负值逐渐增大,即容易低估SaO2,在SpO2<80%时更加明显。

关键词: 脉搏氧饱和度仪;脉氧探头;动脉血氧饱和度
Abstract:

Objective To study the accuracy and characteristic of domestic pulse oximeter(POM) used in healthy volunteers under controlled hypoxemia, and to provide scientific proof for safe and effective clinical application. Methods Healthy volunteers were made hypoxic by inhaling mix gases of oxygen and nitrogen, and were monitored by two pulse oximeters with Masimo and Nellcor pulse probe, respectively. Monitoring interval of pulse oxygen saturation(SpO2) was 70% to 100%. When it reached around the five target values(>95%, 92%, 85%, 78%, 70%), readings of SpO2 were recorded and arterial blood sample were collected at exactly the same time for blood gas analysis. Results Differences of SpO2 detected by Masimo and Nellcor probes with arterial oxygen saturation(SaO2) determined by blood gas analyzer were within the ISO9919:2005 standard range(Arms=2.16 and 2.32, respectively). Bias(SpO2-SaO2) of SpO2 of Masimo probe were 0.93% and -1.45% when SpO2≥80% and <80%, while those of Nellcor probe were 0.16% and -1.91%. There was significant difference between two probes(P<0.01). Conclusions Domestic pulse oximeters using Masimo and Nellcor probe can both accurately reflect the oxygen saturation in different degree of hypoxemia. But the readings of Nellcor probe are generally lower than those of Masimo probe due to different principles. As SpO2 goes down, the bias enlarge towards the negative value, leading underestimation of oxygen saturation, especially when SpO2<80%.

Key words: Pulse Oxemeter; Oxygen Saturation probe; Arterial oxygen saturation