Monga zida wamba mu zochita zachipatala, Mipikisano parameter wodwala kuwunika ndi mtundu wa kwachilengedwenso chizindikiro kwa nthawi yaitali, Mipikisano chizindikiro kudziwika kwa zokhudza thupi ndi pathological udindo wa odwala mu odwala kwambiri, ndi kudzera mu zenizeni nthawi ndi kusanthula basi ndi processing. , kusintha kwapanthawi yake kukhala chidziwitso chowoneka, ma alarm odzidzimutsa komanso kujambula zochitika zomwe zingaike moyo pachiswe. Kuphatikiza pa kuyeza ndi kuyang'anira magawo a thupi la odwala, imathanso kuyang'anira ndi kuthana ndi momwe odwala asanalandire mankhwala ndi opaleshoni asanayambe kapena atatha opaleshoni, kupeza nthawi yake kusintha kwa odwala omwe akudwala kwambiri, ndikupereka maziko ofunikira kwa madokotala fufuzani moyenera ndikukonza mapulani azachipatala, motero kuchepetsa kwambiri kufa kwa odwala omwe akudwala kwambiri.
Ndi chitukuko chaukadaulo, zinthu zowunika za owunikira odwala ambiri zakula kuchokera kumayendedwe ozungulira mpaka kupuma, kwamanjenje, kagayidwe kachakudya ndi machitidwe ena.Mutuwu umakulitsidwanso kuchokera ku ECG module (ECG), kupuma moduli (RESP), mpweya wa oxygen saturation module (SpO2), noninvasive blood pressure module (NIBP) kupita ku gawo la kutentha (TEMP), module yothamanga ya magazi (IBP) , cardiac displacement module (CO), noninvasive continuous cardiac displacement module (ICG), ndi end-breath carbon dioxide module (EtCO2) ), electroencephalogram monitoring module (EEG), anesthesia gas monitoring module (AG), transcutaneous gas monitoring module, anesthesia module yowunikira mozama (BIS), module yowunikira kupuma kwa minofu (NMT), module yowunikira hemodynamics (PiCCO), module yamakina opumira.
Kenako, igawidwa m'magawo angapo kuti iwonetse maziko a thupi, mfundo, chitukuko ndi kugwiritsa ntchito gawo lililonse.Tiyeni tiyambe ndi gawo la electrocardiogram (ECG).
1: Njira yopangira electrocardiogram
Cardiomyocytes kufalitsidwa mu nkusani mfundo, atrioventricular mphambano, atrioventricular thirakiti ndi nthambi zake kupanga magetsi ntchito pa malemeredwe ndi kupanga magetsi minda mu thupi. Kuyika electrode probe zitsulo mu gawo lamagetsi ili (kulikonse m'thupi) akhoza kulemba zofooka zamakono. Malo amagetsi amasintha mosalekeza pamene nthawi yoyenda ikusintha.
Chifukwa cha mitundu yosiyanasiyana yamagetsi ya minofu ndi ziwalo zosiyanasiyana za thupi, ma elekitirodi ofufuza m'madera osiyanasiyana amalemba kusintha kosiyana kwamtundu uliwonse wamtima. Kusintha kwakung'ono kumeneku kumakulitsidwa ndikujambulidwa ndi electrocardiograph, ndipo zotsatira zake zimatchedwa electrocardio-gram (ECG). Electrocardiogram yachikhalidwe imalembedwa kuchokera pamwamba pa thupi, yotchedwa surface electrocardiogram.
2: Mbiri yaukadaulo wa electrocardiogram
Mu 1887, Waller, pulofesa wa physiology pa Mary's Hospital of the Royal Society of England, adalemba bwino nkhani yoyamba ya electrocardiogram ya munthu ndi capillary electrometer, ngakhale kuti mafunde a V1 ndi V2 okha a ventricle analembedwa pa chithunzicho, ndi mafunde a P. sizinalembedwe. Koma ntchito yaikulu ndi yobala zipatso ya Waller inauzira Willem Einthoven, yemwe anali mwa omvera, ndipo anayala maziko kuti pamapeto pake ayambe teknoloji ya electrocardiogram.
------------------------ (AugustusDisire Walle)---------------------- ------------------ (Waller adalemba electrocardiogram yoyamba yamunthu)-------------------------- ------------------------ (Capillary electrometer)------------
Kwa zaka 13 zotsatira, Einthoven anadzipereka kwathunthu ku maphunziro a electrocardiograms olembedwa ndi capillary electrometers. Iye bwino angapo kiyi njira, bwinobwino ntchito chingwe galvanometer, thupi padziko electrocardiogram olembedwa photosensitive filimu, iye analemba electrocardiogram anasonyeza atria P yoweyula, yamitsempha yamagazi depolarization B, C ndi repolarization D yoweyula. Mu 1903, electrocardiograms inayamba kugwiritsidwa ntchito kuchipatala. Mu 1906, Einthoven analemba ma electrocardiograms a atria fibrillation, atrium flutter ndi ventricular premature beat motsatizana. Mu 1924, Einthoven adalandira Mphotho ya Nobel mu Medicine chifukwa chopanga kujambula kwa electrocardiogram.
------------------------------------------------- ------------------------------------True complete electrocardiogram yolembedwa ndi Einthoven------- ------------------------------------------------- ------------------------------------------------
3: Kukula ndi mfundo za dongosolo lotsogolera
Mu 1906, Einthoven anapereka lingaliro la bipolar limb lead. Pambuyo polumikiza ma elekitirodi ojambulira m'dzanja lamanja, mkono wakumanzere ndi mwendo wakumanzere wa odwala awiriawiri, amatha kujambula ma electrocardiogram (lead I, lead II ndi lead III) yokhala ndi matalikidwe apamwamba komanso mawonekedwe okhazikika. Mu 1913, electrocardiogram ya bipolar standard limb conduction electrocardiogram idayambitsidwa, ndipo idagwiritsidwa ntchito yokha kwa zaka 20.
Mu 1933, Wilson potsiriza anamaliza unipolar lead electrocardiogram, yomwe idatsimikiza malo a zero kuthekera komanso pakati pamagetsi apakati malinga ndi malamulo apano a Kirchhoff, ndikukhazikitsa 12-lead system ya Wilson network.
Komabe, mu Wilson's 12-lead system, electrocardiogram waveform amplitude ya 3 unipolar nthambi imatsogolera VL, VR ndi VF ndi yotsika, yomwe si yosavuta kuyeza ndikuwona kusintha. Mu 1942, Goldberger adachita kafukufuku wopitilira, zomwe zidapangitsa kuti miyendo yopanikizidwa ya unipolar yomwe ikugwiritsidwabe ntchito masiku ano: aVL, aVR, ndi aVF lead.
Pakadali pano, makina otsogola a 12 ojambulira ECG adayambitsidwa: 3 bipolar limb lead (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar breast lead (V1-V6, Wilson, 1933), ndi 3 unipolar compression. Limb lead (aVL, aVR, aVF, Goldberger, 1942).
4: Momwe mungapezere chizindikiro chabwino cha ECG
1. Kukonzekera khungu. Popeza khungu ndi woyendetsa bwino, chithandizo choyenera cha khungu la wodwalayo kumene ma electrode amayikidwa ndi kofunika kuti apeze zizindikiro zabwino za magetsi a ECG. Sankhani athyathyathya okhala ndi minofu yochepa
Khungu liyenera kuthandizidwa motsatira njira izi: ① Chotsani tsitsi lapathupi pomwe ma elekitirodi ayikidwa. Pakani pang'onopang'ono pakhungu pomwe ma elekitirodi amayikidwa kuti muchotse maselo akufa. ③ Sambani khungu bwinobwino ndi madzi a sopo (musagwiritse ntchito ether ndi mowa wonyezimira, chifukwa izi zidzawonjezera kukana kwa khungu). ④ Lolani khungu kuti liume kwathunthu musanayike electrode. ⑤ Ikani mabatani kapena mabatani musanayike ma elekitirodi pa wodwalayo.
2. Samalani ndi kukonza waya wa conductance wa mtima, kuletsa kupiringa ndi kulumikiza waya wotsogolera, kuteteza wosanjikiza wotchinga wa waya wotsogolera kuti usawonongeke, ndikuyeretsa nthawi yake dothi pagawo lotsogolera kapena lamba kuti mupewe okosijeni wotsogolera.
Nthawi yotumiza: Oct-12-2023
