Njengezona zixhobo zixhaphakileyo ekusebenzeni kweklinikhi, ukujongwa kwezigulane ezininzi luhlobo lwesignali yebhayoloji yexesha elide, i-multi-parameter ukufumanisa imeko ye-physiological kunye ne-pathological yezigulane kwizigulana ezibucayi, kunye nexesha lokwenyani kunye nohlalutyo oluzenzekelayo kunye nokucubungula. , ukuguqulwa kwangexesha kulwazi olubonakalayo, i-alamu ezenzekelayo kunye nokurekhoda ngokuzenzekelayo iziganeko ezinokuthi zibe yingozi ebomini. Ukongeza ekulinganiseni nasekubekeni iliso kwi parameters ye-physiological yezigulane, inokuphinda ibeke iliso kwaye ijongane nobume bezigulane ngaphambi nangemva kweyeza kunye notyando, ifumane ngexesha elifanelekileyo utshintsho kwimeko yezigulane ezigula kakhulu, kwaye inike isiseko esisisiseko sokuba oogqirha Ukuxilonga ngokuchanekileyo kunye nokwenza izicwangciso zonyango, ngaloo ndlela kuncitshiswa kakhulu ukusweleka kwezigulana ezigula kakhulu.
Ngophuhliso lwethekhnoloji, izinto zokubeka iliso zezigulane ezininzi zeeparameters ziye zanda ukusuka kwinkqubo yokujikeleza ukuya ekuphefumleni, kwi-nervous, metabolic kunye nezinye iinkqubo.Imodyuli iphinde yandiswa ukusuka kwimodyuli ye-ECG esetyenziswa ngokuqhelekileyo (ECG), imodyuli yokuphefumula (RESP), imodyuli ye-oxygen saturation (SpO2), imodyuli ye-blood pressure (NIBP) engavumelekanga (NIBP) kwimodyuli yokushisa (TEMP), imodyuli yoxinzelelo lwegazi (IBP) , imodyuli ye-cardiac displacement module (CO), imodyuli eqhubekayo yokufuduswa kwentliziyo (ICG), kunye nemodyuli yokuphefumla i-carbon dioxide (EtCO2) ), imodyuli yokubeka iliso ye-electroencephalogram (EEG), imodyuli yokubeka iliso yegesi ye-anesthesia (AG), imodyuli yokubeka iliso yegesi ye-transcutaneous, i-anesthesia imodyuli yokuhlola ubunzulu (BIS), imodyuli yokubeka iliso ekuphumleni kwezihlunu (NMT), imodyuli yokubeka iliso kwi-hemodynamics (PiCCO), imodyuli yobumatshini bokuphefumla.
Okulandelayo, iya kwahlulwa ibe ngamacandelo amaninzi ukwazisa isiseko somzimba, umgaqo, uphuhliso kunye nokusetyenziswa kwemodyuli nganye.Masiqale ngemodyuli ye-electrocardiogram (ECG).
1: Indlela yokuvelisa i-electrocardiogram
I-Cardiomyocytes isasazwa kwi-sinus node, i-atrioventricular junction, i-atrioventricular tract kunye namasebe ayo avelisa umsebenzi wombane ngexesha lokuvuselela kunye nokuvelisa iindawo zombane emzimbeni. Ukubeka i-electrode ye-metal probe kule ntsimi yombane (naphi na emzimbeni) inokurekhoda umbane obuthathaka. Intsimi yombane iyatshintsha ngokuqhubekayo njengoko ixesha lokuhamba litshintsha.
Ngenxa yeepropathi ezahlukeneyo zombane zezicubu kunye namalungu ahlukeneyo omzimba, ii-electrode zokuhlola kwiindawo ezahlukeneyo zirekhoda utshintsho olunokwenzeka kumjikelo ngamnye wentliziyo. Olu tshintsho luncinci olunokuthi lukhuliswe kwaye lurekhodwe nge-electrocardiograph, kwaye iphethini ephumelayo ibizwa ngokuba yi-electrocardio-gram (ECG). I-electrocardiogram yesiko irekhodwa kumphezulu womzimba, ebizwa ngokuba yi-surface electrocardiogram.
2: Imbali yetekhnoloji ye-electrocardiogram
Kwi-1887, uWaller, unjingalwazi we-physiology kwisibhedlele sikaMariya saseRoyal Society yaseNgilani, wabhala ngempumelelo imeko yokuqala ye-electrocardiogram yomntu kunye ne-capillary electrometer, nangona kuphela i-V1 kunye ne-V2 yamaza e-ventricle abhalwe kumfanekiso, kunye namaza e-atrial P. azibhalwanga. Kodwa umsebenzi omkhulu kaWaller noneziqhamo waphefumlela uWillem Einthoven, owayekho kubaphulaphuli, waza wabeka isiseko sokuqaliswa kobuchwepheshe be-electrocardiogram.
------------------------ (AugustusDisire Walle)---------------------- ------------------ (UWaller urekhode i-electrocardiogram yomntu yokuqala)--------------------------- -------------------------(Capillary electrometer)------------
Kwiminyaka eyi-13 eyalandelayo, u-Einthoven wazinikela ngokupheleleyo kuphononongo lwee-electrocardiograms ezirekhodwe nge-capillary electrometers. Uphucule inani leendlela eziphambili, usebenzisa ngempumelelo i-galvanometer yentambo, i-electrocardiogram yomzimba erekhodiweyo kwifilimu ye-photosensitive, wabhala i-electrocardiogram ebonisa i-atrial P wave, i-ventricular depolarization B, C kunye ne-repolarization D wave. Ngowe-1903, i-electrocardiograms yaqala ukusetyenziswa eklinikhi. Ngo-1906, u-Einthoven wabhala i-electrocardiograms ye-atrial fibrillation, i-atrial flutter kunye ne-ventricular premature beat ngokulandelanayo. Ngomnyaka we-1924, u-Einthoven wawongwa ngeBhaso leNobel kuNyango ngokuqamba kwakhe ukurekhoda kwe-electrocardiogram.
------------------------------------------------- -----------------------------------Enyanisweni i-electrocardiogram epheleleyo irekhodwe ngu-Einthoven-------- ------------------------------------------------- ------------------------------------------------
3:Uphuhliso kunye nomgaqo wenkqubo yokukhokela
Ngo-1906, u-Einthoven wacebisa ingcamango ye-bipolar limb lead. Emva kokudibanisa i-electrodes yokurekhoda kwingalo yasekunene, ingalo yasekhohlo kunye nomlenze wekhohlo wezigulane ngababini, wayenokurekhoda i-bipolar i-lead electrocardiogram ye-bipolar (i-lead I, i-lead II kunye ne-III) ene-amplitude ephezulu kunye nephethini ezinzileyo. Ngowe-1913, kwaqaliswa ngokusemthethweni i-bipolar limb conduction electrocardiogram, yaye yasetyenziswa iyodwa iminyaka engama-20.
Kwi-1933, uWilson ekugqibeleni wagqiba i-electrocardiogram ehamba phambili ye-unipolar, eyamisela indawo ye-zero enokubakho kunye ne-terminal yombane ephakathi ngokomthetho wangoku waseKirchhoff, kwaye yaseka inkqubo ye-12 ye-Wilson network.
Nangona kunjalo, kwi-Wilson ye-12-lead system, i-electrocardiogram waveform amplitude ye-3 unipolar limb ikhokelela i-VL, i-VR kunye ne-VF iphantsi, okungekho lula ukulinganisa nokugcina utshintsho. Ngo-1942, uGoldberger wenza uphando olongezelelekileyo, nto leyo eyaphumela ekubeni i-unipolar icinezele imilenze ikhokelela ekusasetyenziswayo nanamhlanje: i-aVL, i-aVR, kunye ne-aVF.
Ngeli xesha, inkqubo ye-12 ehamba phambili yokurekhoda i-ECG yaqaliswa: i-3 bipolar limb lead (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), i-6 i-unipolar breast lead (V1-V6, Wilson, 1933), kunye ne-3 i-unipolar compression imilenze ikhokelela (aVL, aVR, aVF, Goldberger, 1942).
4:Ufumana njani umqondiso we-ECG olungileyo
1. Ukulungiswa kwesikhumba. Ekubeni ulusu luyi-conductor ehluphekileyo, unyango olufanelekileyo lwesikhumba sesigulane apho i-electrodes ibekwe khona kuyimfuneko ukufumana iimpawu zombane ze-ECG ezilungileyo. Khetha ezisicaba ezinezihlunu ezincinci
Ulusu kufuneka luphathwe ngokwezi ndlela zilandelayo: ① Susa iinwele zomzimba apho i-electrode ibekwe khona. Gcoba ngobunono ulusu apho i-electrode ibekwe khona ukususa iiseli zesikhumba ezifileyo. ③ Hlamba ulusu ngokucokisekileyo ngamanzi anesepha (ungasebenzisi i-ether kunye notywala obucocekileyo, kuba oku kuya kwandisa ukuxhathisa kwesikhumba). ④ Vumela ulusu ukuba lome ngokupheleleyo ngaphambi kokubeka i-electrode. ⑤ Faka i-clamps okanye amaqhosha ngaphambi kokubeka i-electrode kwisigulane.
2. Nika ingqalelo ekugcinweni kocingo lwe-cardiac conductance, ukunqanda ukujija kunye nokubopha ucingo olukhokelayo, ukuthintela ukhuselo lwentambo yocingo ukuba lungonakaliswe, kwaye ngexesha elifanelekileyo ucoce ukungcola kwi-clip ye-lead okanye i-buckle ukukhusela i-oxidation ye-lead.
Ixesha lokuposa: Oct-12-2023
