摘要目的 探讨脉搏血氧饱和度(SpO2)在急诊低氧血症患者中的危险分层,为病情危重程度的识别提供依据.方法 采用自行设计的《急诊低氧血症患者临床资料登记表》,前瞻性收集2018年3-4月北京协和医院急诊科344例低氧血症患者临床资料,包括基线资料(姓名、性别、年龄、ID号、日期、挂号时间)、来院方式、既往史、患者主诉和诊断、分诊级别、SpO2、是否即刻入抢救室等.结果 344例急诊低氧血症患者中,急救车163例占47.4%,需即刻入抢救室患者107例占31.1%;白班(8:00-20:00)与夜班(20:00-次日8:00)需即刻入抢救室患者分别为54例占25.7%与53例占39.6%,以9:00-10:00、14:00-15:00、20:00-24:00居多;患者在来院方式、分诊分级和SpO2方面对是否需要即刻入抢救室差异有统计学意义(χ2=29.537、25.780,t=4.722,均P＜0.05);未患肺部疾病患者SpO2危险分层为0.905;患有肺部疾病患者SpO2危险分层为0.765.结论 低氧血症患者在急诊占有一定比例且病情危重,可依据是否患有肺部疾病针对性评估患者病情危重程度,并借助SpO2精准确定患者危险分层,以进一步指导急诊低氧血症患者分级诊疗措施和合理优化急诊资源配置.

abstractsObjective To explore the risk stratification of pulse oxygen saturation (SpO2) in patients with emergency hypoxemia patients, and to provide evidence for the identification of critical illness. Methods Self-designed clinical data registration form for patients with emergency hypoxemia , and prospective collection of 344 hypoxemia patients in the emergency department of Peking Union Medical College Hospital from March to April in 2018, including baseline data (name, gender, age, ID number, date, registration time), hospitalization method, past history, patient complaint and diagnosis, triage level, SpO2, whether to enter the rescue room, etc. Results All of 344 emergency hypoxemia patients, there were 163 cases (21.2% ) of ambulances, and 107 cases (31.1% ) of patients requiring immediate rescue. There were 54 cases (25.7%) and 53 cases (39.6%) in need of immediate rescue in day shift (8:00-20:00) and night shift (20:00-8:00 next day), with 9:00-10:00, 14:00-15:00, 20:00-24:00 in the majority. There was a statistical difference in the way of hospitalization, triage, and SpO(2 25.780, t=4.722, all P<0.05). SpO2 risk stratification was 0.905 in patients without pulmonary disease, and SpO2 risk stratification in patients with lung disease was 0.765. Conclusions Patients with hypoxemia account for a certain proportion in the emergency department and are in critical condition. The degree of critical condition of patients can be evaluated based on whether they have lung diseases, and the risk stratification of patients can be accurately determined with the help of SpO2, so as to further guide the hierarchical treatment measures for patients with emergency hypoxemia and rationally optimize the χ2=29.537, allocation of emergency resources.