Njengemishini evame kakhulu emtholampilo, i-multi-parameter patient monitor iwuhlobo lwesignali yezinto eziphilayo yokubona isikhathi eside, amapharamitha amaningi isimo somzimba nesokugula kweziguli ezigulini ezibucayi, kanye nokuhlaziywa nokucubungula kwesikhathi sangempela kanye nokuzenzakalelayo, ukuguqulwa ngesikhathi esifanele kube ulwazi olubonakalayo, i-alamu ezenzakalelayo kanye nokuqoshwa okuzenzakalelayo kwezehlakalo ezingaba yingozi empilweni. Ngaphezu kokulinganisa nokuqapha amapharamitha omzimba weziguli, ingaqapha futhi ibhekane nesimo seziguli ngaphambi nangemva kokwelashwa nokuhlinzwa, ithole izinguquko esimweni seziguli ezigula kakhulu ngesikhathi esifanele, futhi inikeze isisekelo esiyisisekelo sodokotela sokuxilonga nokwakha izinhlelo zezokwelapha ngendlela efanele, ngaleyo ndlela inciphise kakhulu ukufa kweziguli ezigula kakhulu.
Ngokuthuthuka kobuchwepheshe, izinto zokuqapha zeziguli ezinamapharamitha amaningi ziye zanda kusukela ohlelweni lokujikeleza kwegazi kuya ezinhlelweni zokuphefumula, ezemizwa, eze-metabolic kanye nezinye.Le module iphinde yandiswa kusukela kumoduli ye-ECG esetshenziswa kakhulu (ECG), imoduli yokuphefumula (RESP), imoduli yokugcwala komoya-mpilo egazini (SpO2), imoduli yomfutho wegazi engangenisi (NIBP) kuya kumoduli yokushisa (TEMP), imoduli yomfutho wegazi engangenisi (IBP), imoduli yokufuduka kwenhliziyo (CO), imoduli yokufuduka kwenhliziyo engangenisisi (ICG), kanye nemoduli ye-carbon dioxide yokuphela kokuphefumula (EtCO2)), imoduli yokuqapha i-electroencephalogram (EEG), imoduli yokuqapha igesi ye-anesthesia (AG), imoduli yokuqapha igesi ye-transcutaneous, imoduli yokuqapha ukujula kwe-anesthesia (BIS), imoduli yokuqapha ukuphumula kwemisipha (NMT), imoduli yokuqapha i-hemodynamics (PiCCO), imoduli yemishini yokuphefumula.
Okulandelayo, kuzohlukaniswa izingxenye eziningana ukuze kwethulwe isisekelo somzimba, isimiso, intuthuko kanye nokusetshenziswa kwemodyuli ngayinye.Ake siqale nge-electrocardiogram module (ECG).
1: Indlela yokukhiqizwa kwe-electrocardiogram
Ama-cardiomyocyte asatshalaliswa ku-sinus node, i-atrioventricular junction, i-atrioventricular tract kanye namagatsha ayo akhiqiza umsebenzi kagesi ngesikhathi sokuvuselela futhi akhiqize amasimu kagesi emzimbeni. Ukubeka i-electrode ye-probe yensimbi kule nsimu kagesi (noma kuphi emzimbeni) kungaqopha ugesi obuthakathaka. Insimu kagesi iyashintsha njalo njengoba isikhathi sokunyakaza sishintsha.
Ngenxa yezakhiwo zikagesi ezahlukene zezicubu nezingxenye ezahlukene zomzimba, ama-electrode okuhlola ezingxenyeni ezahlukene aqophe izinguquko ezahlukene ezingaba khona emjikelezweni ngamunye wenhliziyo. Lezi zinguquko ezincane ezingaba khona ziyandiswa futhi ziqoshwe yi-electrocardiograph, futhi iphethini ephumayo ibizwa ngokuthi i-electrocardiogram (ECG). I-electrocardiogram yendabuko iqoshwa ebusweni bomzimba, ebizwa ngokuthi i-surface electrocardiogram.
2: Umlando wobuchwepheshe be-electrocardiogram
Ngo-1887, uWaller, uprofesa we-physiology eMary's Hospital yeRoyal Society of England, waqopha ngempumelelo icala lokuqala le-electrocardiogram yomuntu nge-capillary electrometer, yize kuphela amagagasi e-V1 ne-V2 e-ventricle aqoshwa esithombeni, kanti amagagasi e-atrial P awaqoshwanga. Kodwa umsebenzi omkhulu nothelayo kaWaller waphefumulela uWillem Einthoven, owayekhona ezilalelini, futhi wabeka isisekelo sokwethulwa kobuchwepheshe be-electrocardiogram ekugcineni.
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Eminyakeni eyi-13 eyalandela, u-Einthoven wazinikela ngokuphelele ekufundeni ama-electrocardiogram aqoshwe ngama-capillary electrometer. Wathuthukisa amasu amaningana abalulekile, esebenzisa ngempumelelo i-string galvanometer, i-electrocardiogram yomzimba eqoshwe kwifilimu ezwela ukukhanya, waqopha i-electrocardiogram ekhombisa i-atrial P wave, i-ventricular depolarization B, C kanye ne-repolarization D wave. Ngo-1903, ama-electrocardiogram aqala ukusetshenziswa ngokwezokwelapha. Ngo-1906, u-Einthoven waqopha ama-electrocardiogram e-atrial fibrillation, i-atrial flutter kanye ne-ventricular premature beat ngokulandelana. Ngo-1924, u-Einthoven wanikezwa uMklomelo KaNobel Kwezokwelapha ngokusungula kwakhe ukuqoshwa kwe-electrocardiogram.
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3: Ukuthuthukiswa kanye nesimiso sesistimu yokuhola
Ngo-1906, u-Einthoven waphakamisa umqondo we-bipolar limb lead. Ngemva kokuxhuma ama-electrode okuqopha engalweni yesokudla, engalweni yesobunxele kanye nasemlenzeni wesobunxele weziguli ngababili, wayekwazi ukuqopha i-bipolar limb lead electrogram (lead I, lead II kanye ne-lead III) nge-amplitude ephezulu kanye nephethini ezinzile. Ngo-1913, i-bipolar standard limb conduction electrocardiogram yethulwa ngokusemthethweni, futhi yasetshenziswa yodwa iminyaka engama-20.
Ngo-1933, uWilson waqeda i-electrocardiogram ye-lead ye-unipolar, eyanquma indawo ye-zero potential kanye ne-central electric terminal ngokusho komthetho wamanje kaKirchhoff, futhi yasungula uhlelo lwe-12-lead lwenethiwekhi yeWilson.
Kodwa-ke, ohlelweni lukaWilson olunezinti ezingu-12, ubukhulu be-electrocardiogram waveform yama-lead amathathu e-unipolar limb VL, VR kanye ne-VF buphansi, okungelula ukukala nokubona izinguquko. Ngo-1942, uGoldberger wenza ucwaningo olwengeziwe, okwaholela kuma-lead e-unipolar pressurized limbs asasetshenziswa nanamuhla: ama-lead e-aVL, aVR, kanye ne-aVF.
Kuleli qophelo, uhlelo olujwayelekile lwe-12-lead lokuqopha i-ECG lwasungulwa: ama-bipolar limb lead amathathu (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), ama-unipolar breast lead ayisithupha (V1-V6, Wilson, 1933), kanye nama-unipolar compression limb lead amathathu (aVL, aVR, aVF, Goldberger, 1942).
4: Indlela yokuthola isignali enhle ye-ECG
1. Ukulungiswa kwesikhumba. Njengoba isikhumba singabambi kahle, ukwelashwa okufanele kwesikhumba sesiguli lapho kufakwa khona ama-electrode kuyadingeka ukuze kutholakale izimpawu zikagesi ezinhle ze-ECG. Khetha ezisicaba ezinemisipha emincane
Isikhumba kufanele siphathwe ngalezi zindlela ezilandelayo: ① Susa uboya bomzimba lapho kufakwa khona i-electrode. Hlikihla isikhumba kancane lapho kufakwa khona i-electrode ukuze ususe amangqamuzana esikhumba afile. ③ Geza isikhumba kahle ngamanzi anensipho (ungasebenzisi i-ether notshwala obumsulwa, ngoba lokhu kuzokwandisa ukumelana kwesikhumba). ④ Vumela isikhumba some ngokuphelele ngaphambi kokubeka i-electrode. ⑤ Faka ama-clamp noma izinkinobho ngaphambi kokubeka ama-electrode esigulini.
2. Naka ukunakekelwa kwentambo yokuhambisa umoya, vimbela ukugoqa nokubopha intambo yokudonsa, vimbela ungqimba lokuvikela lwentambo yokudonsa ukuthi lungalimali, bese uhlanza ukungcola okusesiqeshaneni sokudonsa noma ibhande ngesikhathi esifanele ukuze uvimbele ukuminyana kwentambo yokudonsa.
Isikhathi sokuthunyelwe: Okthoba-12-2023
