DIRECT MEASUREMENT OF WOUND AND TISSUE OXYGEN-TENSION IN POSTOPERATIVE-PATIENTS
DIRECT MEASUREMENT OF WOUND AND TISSUE OXYGEN-TENSION IN POSTOPERATIVE-PATIENTS
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DOI：
10.1097/00000658-198304000-00017
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发表时间：
1983-01-01
影响因子：
9
通讯作者：
HUNT, TK
中科院分区：
文献类型：
--
作者：
CHANG, N;GOODSON, WH;HUNT, TK
使用植入式硅橡胶导管技术测量33例术后患者手臂皮下组织中乳房切除术伤口和针诱导伤口的O2分压[PO2]，以评估手术当天和术后第5天的组织伤口氧合和灌注。观察到特征模式。伤口缺氧是常见的，最明显的腹部，血管和心脏手术后。手术后立即最为严重。临床评价不易检测到组织缺氧，经验丰富的外科医生在不知不觉中耐受了组织缺氧。动脉[a]和组织PO2之间的关系是双相的，并且在PaO2的较低范围内可能是曲线的，并且甚至在Hb完全饱和点以上线性上升。在19次测量中，19次的补充性推注液体输注升高了受压组织的PO2，表明低血容量是术后组织缺氧的常见原因。组织PO2的测量，再加上一个单一的动脉O2测定，构成了一个临床上有用的手段，监测组织灌注。
An implanted Silastic catheter technique was used to measure O2 partial pressure [PO2] in mastectomy wounds and needle-induced wounds in the subcutaneous tissue of the arms of 33 postoperative patients to assess tissue-wound oxygenation and perfusion on the day of operation and daily through postoperative day 5. Characteristic patterns were observed. Wound hypoxia was common and most pronounced after abdominal, vascular and cardiac procedures. It was most severe immediately after operation. Tissue hypoxia was not easily detected by clinical evaluation and was unknowingly tolerated by experienced surgeons. The relationship between arterial [a] and tissue PO2 is biphasic, and presumably curvilinear at the lower range of PaO2 and rises linearly even above the point of full saturation of Hb. Supplemental bolus fluid infusion elevated depressed tissue PO2 in 19 of 19 measurements, implicating hypovolemia as a common cause of postoperative tissue hypoxia. Measurements of tissue PO2, coupled with a single arterial O2 determination, constitute a clinically useful means of monitoring tissue perfusion.