Njengomshini ovame kakhulu ekusebenzeni komtholampilo, ukuqapha kwesiguli esinepharamitha ehlukahlukene kuwuhlobo lwesiginali yebhayoloji yokutholwa kwepharamitha yesikhathi eside, yesimo somzimba kanye nese-pathological seziguli ezigulini ezibucayi, nangokuhlaziywa kwesikhathi sangempela nokuzenzakalelayo nokucubungula. , ukuguqulwa okufika ngesikhathi kulwazi olubukwayo, i-alamu ezenzakalelayo nokuqoshwa okuzenzakalelayo kwezenzakalo ezingaba yingozi empilweni. Ngaphezu kokulinganisa nokuqapha imingcele yokuphila kweziguli, ingakwazi futhi ukuqapha futhi ibhekane nesimo seziguli ngaphambi nangemva kwemithi nokuhlinzwa, ithole ngesikhathi esifanele izinguquko esimweni seziguli ezigula kakhulu, futhi inikeze isisekelo esiyisisekelo sokuthi odokotela xilonga ngendlela efanele futhi wenze izinhlelo zezokwelapha, ngaleyo ndlela kunciphisa kakhulu ukufa kweziguli ezigula kakhulu.
Ngokuthuthuka kobuchwepheshe, izinto zokuqapha zabaqaphi beziguli ezinamapharamitha amaningi ziye zanda kusukela ohlelweni lokujikeleza kwegazi kuya ekuphefumuleni, kwemizwa, kwe-metabolic nezinye izinhlelo.I-module iphinde inwetshwe kusukela kumojula ye-ECG evame ukusetshenziswa (ECG), imodyuli yokuphefumula (RESP), imodyuli ye-blood oxygen saturation (SpO2), imodyuli ye-blood pressure (NIBP) engavamile (NIBP) kuya kumojula yokushisa (TEMP), imodyuli yomfutho wegazi ongenayo (IBP) , imojula ye-cardiac displacement (CO), module eqhubekayo yokufuduka kwenhliziyo engapheli (ICG), kanye nemodule yokuphefumula kwe-carbon dioxide (EtCO2) ), i-electroencephalogram monitoring module (EEG), i-anesthesia gas monitoring module (AG), i-transcutaneous gas monitoring module, i-anesthesia imojula yokuqapha ukujula (BIS), imojula yokuqapha ukuphumula kwemisipha (NMT), imojula yokuqapha i-hemodynamics (PiCCO), imojula yemishini yokuphefumula.
Okulandelayo, izohlukaniswa izingxenye eziningana ukwethula isisekelo sokuphila, isimiso, ukuthuthukiswa kanye nokusetshenziswa kwemojula ngayinye.Ake siqale nge-electrocardiogram module (ECG).
1: Indlela yokukhiqiza i-electrocardiogram
Ama-cardiomyocyte asatshalaliswa ku-sinus node, ukuhlangana kwe-atrioventricular, ipheshana le-atrioventricular kanye namagatsha awo akhiqiza umsebenzi kagesi ngesikhathi se-excitation futhi akhiqize amasimu kagesi emzimbeni. Ukubeka i-electrode ye-metal probe kule nkundla kagesi (noma yikuphi emzimbeni) kungarekhoda amandla amanje abuthakathaka. Inkambu kagesi ishintsha ngokuqhubekayo njengoba isikhathi sokunyakaza sishintsha.
Ngenxa yezakhiwo ezihlukene zikagesi zezicubu nezingxenye ezihlukene zomzimba, ama-electrode okuhlola ezingxenyeni ezihlukene aqopha izinguquko ezingaba khona ezihlukahlukene emjikelezweni ngamunye wenhliziyo. Lezi zinguquko ezincane ezingenzeka zikhuliswa futhi zirekhodwe nge-electrocardiograph, futhi iphethini ewumphumela ibizwa ngokuthi i-electrocardio-gram (ECG). I-electrocardiogram yendabuko irekhodwa ebusweni bomzimba, ebizwa ngokuthi i-surface electrocardiogram.
2:Umlando wobuchwepheshe be-electrocardiogram
Ngo-1887, u-Waller, uprofesa we-physiology e-Mary's Hospital ye-Royal Society of England, wabhala ngempumelelo icala lokuqala le-electrocardiogram yomuntu nge-capillary electrometer, nakuba amagagasi e-V1 kuphela kanye ne-V2 kuphela e-ventricle aqoshiwe, kanye namagagasi e-atrial P. akurekhodwanga. Kodwa umsebenzi kaWaller omkhulu futhi onezithelo waphefumulela uWillem Einthoven, owayesezithamelini, futhi wabeka isisekelo sokwethulwa kobuchwepheshe be-electrocardiogram ekugcineni.
------------------------ (AugustusDisire Walle)---------------------- ----------------- (U-Waller uqophe i-electrocardiogram yomuntu yokuqala)-------------------------- ------------------------ (Capillary electrometer)------------
Eminyakeni engu-13 eyalandela, u-Einthoven wazinikela ngokuphelele ekuhloleni ama-electrocardiograms aqoshwe ama-capillary electrometers. Wathuthukisa amasu amaningi ayisihluthulelo, esebenzisa ngempumelelo i-galvanometer yentambo, i-electrocardiogram yobuso bomzimba eqoshwe efilimini ye-photosensitive, wabhala i-electrocardiogram yabonisa i-atrial P wave, i-ventricular depolarization B, C kanye ne-repolarization D wave. Ngo-1903, ama-electrocardiograms aqala ukusetshenziswa emtholampilo. Ngo-1906, u-Einthoven waqopha ama-electrocardiograms e-atrial fibrillation, i-atrial flutter kanye ne-ventricular premature beat ngokulandelana. Ngo-1924, u-Einthoven waklonyeliswa ngeNobel Prize in Medicine ngokusungula kwakhe ukuqoshwa kwe-electrocardiogram.
------------------------------------------------- -----------------------------------I-electrocardiogram ephelele yeqiniso eqoshwe ngu-Einthoven------- ------------------------------------------------- ------------------------------------------------
3:Ukuthuthukiswa kanye nomgomo wohlelo lokuhola
Ngo-1906, u-Einthoven waphakamisa umqondo wokuhola kwemilenze eguquguqukayo. Ngemva kokuxhuma ama-electrode okurekhoda engalweni yesokudla, engalweni yesokunxele nomlenze wesokunxele weziguli ngababili, wayengarekhoda i-electrocardiogram ye-bipolar i-lead lead (lead I, lead II kanye ne-lead III) ene-amplitude ephezulu nephethini ezinzile. Ngo-1913, kwethulwa ngokusemthethweni i-electrocardiogram ye-bipolar standard limb conduction, futhi yasetshenziswa iyodwa iminyaka engu-20.
Ngo-1933, uWilson ekugcineni waqeda i-electrocardiogram ehamba phambili ye-unipolar, eyanquma isikhundla se-zero engaba khona kanye nesiphetho sikagesi esimaphakathi ngokuvumelana nomthetho wamanje we-Kirchhoff, futhi yasungula uhlelo lwe-12-lead yenethiwekhi ye-Wilson.
Kodwa-ke, ohlelweni luka-Wilson lwe-lead eyi-12, i-electrocardiogram waveform amplitude ye-3 unipolar limb ihola i-VL, i-VR ne-VF iphansi, okungelula ukukala nokubheka izinguquko. Ngo-1942, i-Goldberger yenza ucwaningo olwengeziwe, okwaholela emithonjeni ye-unipolar ecindezelweyo esasetshenziswa nanamuhla: imikhondo ye-aVL, i-aVR, ne-aVF.
Kuleli qophelo, isistimu yokuhola engu-12 yokurekhoda i-ECG yethulwa: 3 umthofu we-bipolar (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar breast lead (V1-V6, Wilson, 1933), kanye nokucindezelwa kwe-unipolar okungu-3 izitho zomzimba (aVL, aVR, aVF, Goldberger, 1942).
4:Indlela yokuthola isignali ye-ECG enhle
1. Ukulungiswa kwesikhumba. Njengoba isikhumba singumqhubi ompofu, ukwelashwa okufanele kwesikhumba sesiguli lapho kufakwa khona ama-electrode kuyadingeka ukuze uthole izimpawu ezinhle zikagesi ze-ECG. Khetha eziyisicaba ezinemisipha emincane
Isikhumba kufanele selashwe ngalezi zindlela ezilandelayo: ① Khipha uboya bomzimba lapho i-electrode ibekwe khona. Gcoba ngobumnene isikhumba lapho i-electrode ibekwe khona ukuze ususe amaseli esikhumba afile. ③ Geza isikhumba kahle ngamanzi anensipho (ungasebenzisi i-ether notshwala obuhlanzekile, ngoba lokhu kuzokwandisa ukumelana kwesikhumba). ④ Vumela isikhumba ukuba some ngokuphelele ngaphambi kokubeka i-electrode. ⑤ Faka izinsimbi noma izinkinobho ngaphambi kokubeka ama-electrode esigulini.
2. Naka ukugcinwa kocingo lwe-cardiac conductance, vimbela ukusongwa nokubopha ucingo lomthofu, vimbela ungqimba oluvikelayo locingo lomthofu ukuthi lungonakali, futhi uhlanze ngesikhathi esifanele ukungcola okukusiqeshana somthofu noma ibhande ukuze uvimbele i-oxidation yomthofu.
Isikhathi sokuthumela: Oct-12-2023
