Raws li cov cuab yeej siv tshaj plaws hauv kev kho mob, ntau qhov ntsuas tus neeg mob saib xyuas yog ib hom kab mob lom rau lub sijhawm ntev, ntau qhov ntsuas ntawm lub cev thiab cov kab mob pathological ntawm cov neeg mob hauv cov neeg mob hnyav, thiab los ntawm lub sijhawm tiag tiag thiab tsis siv neeg tsom xam thiab kev ua haujlwm. , hloov raws sij hawm rau hauv cov ntaub ntawv pom, tsis siv neeg lub tswb thiab tsis siv neeg kaw cov xwm txheej uas muaj feem cuam tshuam rau lub neej. Ntxiv nrog rau kev ntsuas thiab saib xyuas lub cev tsis muaj zog ntawm cov neeg mob, nws tseem tuaj yeem saib xyuas thiab cuam tshuam nrog cov xwm txheej ntawm cov neeg mob ua ntej thiab tom qab noj tshuaj thiab phais, tshawb pom cov kev hloov pauv ntawm cov neeg mob hnyav, thiab muab lub hauv paus rau cov kws kho mob. kuaj xyuas kom raug thiab tsim cov phiaj xwm kho mob, yog li txo qis kev tuag ntawm cov neeg mob hnyav.
Nrog rau txoj kev loj hlob ntawm thev naus laus zis, kev soj ntsuam cov khoom ntawm ntau qhov ntsuas tus neeg mob tau nthuav dav los ntawm cov hlab ntsha mus rau kev ua pa, paj hlwb, metabolic thiab lwm yam.Lub module kuj tau nthuav dav los ntawm cov khoom siv ECG module (ECG), ua pa module (RESP), ntshav oxygen saturation module (SpO2), noninvasive blood pressure module (NIBP) mus rau kub module (TEMP), invasive blood pressure module (IBP) , cardiac displacement module (CO), noninvasive nruam cardiac displacement module (ICG), thiab kawg-ua pa carbon dioxide module (EtCO2), electroencephalogram xyuas module (EEG), tshuaj loog roj tshuaj xyuas module (AG), transcutaneous roj xyuas module, tshuaj loog Kev soj ntsuam qhov tob (BIS), kev soj ntsuam cov leeg nqaij so (NMT), hemodynamics saib xyuas module (PiCCO), ua pa tshuab ua pa module.
Tom ntej no, nws yuav muab faib ua ob peb ntu los qhia txog lub hauv paus ntawm lub cev, lub hauv paus ntsiab lus, kev loj hlob thiab kev siv ntawm txhua qhov module.Cia peb pib nrog electrocardiogram module (ECG).
1: Lub tshuab ntawm electrocardiogram ntau lawm
Cardiomyocytes faib nyob rau hauv lub sinus node, atrioventricular hlws ris, atrioventricular kab mob thiab nws cov ceg tsim hluav taws xob kev ua si thaum excitation thiab tsim hluav taws xob teb nyob rau hauv lub cev. Muab cov hlau sojntsuam electrode rau hauv qhov hluav taws xob no (txhua qhov chaw hauv lub cev) tuaj yeem kaw qhov tsis muaj zog tam sim no. Lub tshuab hluav taws xob hloov tsis tu ncua raws li lub sijhawm hloov pauv.
Vim tias cov khoom siv hluav taws xob sib txawv ntawm cov ntaub so ntswg thiab qhov sib txawv ntawm lub cev, kev tshawb nrhiav electrodes nyob rau hauv ntau qhov chaw tau sau cov kev hloov pauv txawv hauv txhua lub voj voog. Cov kev hloov pauv me me no tau nthuav dav thiab kaw los ntawm electrocardiograph, thiab cov qauv tshwm sim hu ua electrocardio-gram (ECG). Cov tshuaj electrocardiogram yog sau los ntawm qhov chaw ntawm lub cev, hu ua nto electrocardiogram.
2: Keeb kwm ntawm electrocardiogram technology
Xyoo 1887, Waller, tus xibfwb ntawm lub cev nqaij daim tawv ntawm Mary's Tsev Kho Mob ntawm Royal Society of England, tau ua tiav thawj kis ntawm tib neeg electrocardiogram nrog capillary electrometer, txawm hais tias tsuas yog V1 thiab V2 nthwv dej ntawm lub ventricle tau sau tseg hauv daim duab, thiab atrial P nthwv dej. tsis tau sau tseg. Tab sis Waller txoj haujlwm zoo thiab muaj txiaj ntsig tau tshoov siab Willem Einthoven, uas yog nyob rau hauv cov neeg tuaj saib, thiab tau tso lub hauv paus rau qhov kev taw qhia txog kev siv tshuab electrocardiogram.
----------------------- (AugustusDisire Walle)-------------------------------- -------------------- (Waller sau thawj tus tib neeg electrocardiogram)-------------------------------- ----------------------- (Capillary electrometer) ----------
Rau 13 xyoo tom ntej no, Einthoven mob siab rau nws tus kheej nkaus rau txoj kev kawm ntawm electrocardiograms kaw los ntawm capillary electrometers. Nws tau txhim kho ntau yam txuj ci tseem ceeb, ua tiav siv txoj hlua galvanometer, lub cev nto electrocardiogram kaw rau hauv cov duab photosensitive, nws tau sau cov electrocardiogram pom lub atrial P yoj, ventricular depolarization B, C thiab repolarization D yoj. Nyob rau hauv 1903, electrocardiograms tau pib siv tshuaj kho mob. Nyob rau hauv 1906, Einthoven tau sau cov electrocardiograms ntawm atrial fibrillation, atrial flutter thiab ventricular ntxov ntxov ua tiav. Xyoo 1924, Einthoven tau txais txiaj ntsig Nobel nqi zog hauv tshuaj rau nws qhov kev tsim kho ntawm electrocardiogram kaw.
------------------------------------------------------ ------------------------- Muaj tseeb ua tiav electrocardiogram kaw los ntawm Einthoven--------- ------------------------------------------------------ --------------------------------------------------
3: Kev tsim kho thiab txoj cai ntawm cov hlau lead
Xyoo 1906, Einthoven tau tsim lub tswv yim ntawm bipolar limb lead. Tom qab txuas cov ntaubntawv povthawj siv electrodes ntawm sab caj npab, sab caj npab thiab sab laug ceg ntawm cov neeg mob nyob rau hauv ua khub, nws muaj peev xwm sau bipolar limb lead electrocardiogram (lead I, lead II thiab lead III) nrog siab amplitude thiab ruaj khov qauv. Xyoo 1913, tus qauv bipolar tus qauv limb conduction electrocardiogram tau raug qhia, thiab nws tau siv ib leeg rau 20 xyoo.
Nyob rau hauv 1933, Wilson thaum kawg ua tiav lub unipolar lead electrocardiogram, uas txiav txim siab txoj hauj lwm ntawm xoom muaj peev xwm thiab lub hauv paus hluav taws xob davhlau ya nyob twg raws li Kirchhoff txoj cai tam sim no, thiab tsim 12-lead system ntawm Wilson network.
Txawm li cas los xij, hauv Wilson's 12-lead system, electrocardiogram waveform amplitude ntawm 3 unipolar limb ua rau VL, VR thiab VF yog qhov tsawg, uas tsis yooj yim rau kev ntsuas thiab saib cov kev hloov pauv. Xyoo 1942, Goldberger tau tshawb fawb ntxiv, uas ua rau lub cev tsis muaj zog ntawm ceg tawv uas tseem siv niaj hnub no: aVL, aVR, thiab aVF coj.
Nyob rau ntawm lub sijhawm no, tus qauv 12-txheej txheem rau kev kaw ECG tau qhia: 3 txoj hlab ntsha bipolar (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar mis leads (V1-V6, Wilson, 1933), thiab 3 unipolar compression limb leads (aVL, aVR, aVF, Goldberger, 1942).
4: Yuav ua li cas kom tau txais ECG teeb liab zoo
1. Kev npaj daim tawv nqaij. Txij li thaum daim tawv nqaij yog ib tug tsis zoo conductor, kev kho kom zoo ntawm tus neeg mob daim tawv nqaij qhov twg cov electrodes raug muab tso rau yog tsim nyog kom tau zoo ECG hluav taws xob signals. Xaiv cov tiaj tus uas tsis muaj cov leeg
Cov tawv nqaij yuav tsum tau kho raws li cov hauv qab no: ① Tshem tawm cov plaub hau lub cev qhov twg cov electrode muab tso rau. Maj mam rub daim tawv nqaij qhov twg cov electrode muab tso rau tshem tawm cov tawv nqaij tuag. ③ Ntxuav daim tawv nqaij kom huv si nrog dej xab npum (tsis txhob siv ether thiab cawv ntshiab, vim qhov no yuav ua rau kom cov tawv nqaij tiv thaiv). ④ Cia cov tawv nqaij kom qhuav tag ua ntej muab cov electrode. ⑤ Nruab cov clamps lossis cov nyees khawm ua ntej muab cov electrodes rau tus neeg mob.
2. Ua tib zoo saib xyuas qhov kev saib xyuas ntawm lub plawv conductance hlau, txwv tsis pub winding thiab knotting cov hlau lead, tiv thaiv cov txheej txheem ntawm cov hlau lead los ntawm kev puas tsuaj, thiab tu cov av raws sij hawm ntawm cov hlau lead clip los yog buckle los tiv thaiv cov hlau lead oxidation.
Post lub sij hawm: Oct-12-2023
