Semuchina unonyanya kushandiswa mukurapa, multi-parameter patient monitor rudzi rwechiratidzo chebhayoloji chekuona kwenguva refu, multi-parameter mamiriro emuviri uye ezvirwere zvevarwere muvarwere vakaoma, uye kuburikidza nekuongorora nekugadzirisa kwenguva chaiyo uye otomatiki, kushandurwa panguva yakakodzera kuita ruzivo rwekuona, alarm otomatiki uye kurekodha otomatiki zviitiko zvinogona kutyisidzira hupenyu. Kuwedzera pakuyera nekutarisa parameters dzemuviri dzevarwere, inogona zvakare kutarisa uye kubata nemamiriro evarwere vasati vatora mishonga nekuvhiyiwa uye mushure mekuvhiyiwa, kuwana shanduko mumamiriro evarwere vakaoma, uye kupa hwaro hwakakosha hwevanachiremba kuti vaongorore nemazvo uye vagadzire zvirongwa zvekurapa, nokudaro zvichideredza zvikuru kufa kwevarwere vakaoma.
Nekuvandudzwa kwetekinoroji, zvinhu zvekutarisa zvevacherechedzi vevarwere vane ma parameter akawanda zvakawedzera kubva pahurongwa hweropa kusvika pahurongwa hwekufema, hwetsinga, hwemetabolism nedzimwe nzira.Module iyi yakawedzerwawo kubva paECG module (ECG) inowanzoshandiswa, respiratory module (RESP), blood oxygen saturation module (SpO2), noninvasive blood pressure module (NIBP) kuenda ku temperature module (TEMP), invasive blood pressure module (IBP), cardiac displacement module (CO), noninvasive continuous cardiac displacement module (ICG), uye end-breath carbon dioxide module (EtCO2) ), electroencephalogram monitoring module (EEG), anesthesia gas monitoring module (AG), transcutaneous gas monitoring module, anesthesia depth monitoring module (BIS), muscle relaxation monitoring module (NMT), hemodynamics monitoring module (PiCCO), respiratory mechanics module.
Tevere, ichakamurwa kuita zvikamu zvakati wandei kuti iunze hwaro hwemuviri, musimboti, kukura uye mashandisirwo emodule yega yega.Ngatitangei ne electrocardiogram module (ECG).
1: Maitiro ekugadzirwa kwe electrocardiogram
Ma "cardiomyocytes" akapararira mu "sinus node", "atrioventricular junction", "atrioventricular tract" nematavi ayo anogadzira mashandiro emagetsi panguva yekukurudzira uye kugadzira minda yemagetsi mumuviri. Kuisa electrode yesimbi mu "electrical field" iyi (chero kupi mumuviri) kunogona kunyora simba remagetsi risina simba. "Electrical field" inochinja nguva nenguva sezvo nguva yekufamba ichichinja.
Nekuda kwehunhu hwakasiyana hwemagetsi hwematishu nezvikamu zvakasiyana zvemuviri, maerekitironi ekutsvaga muzvikamu zvakasiyana akanyora shanduko dzakasiyana dzinogona kuitika muchikamu chega chega chemoyo. Shanduko diki idzi dzinogona kuitika dzinowedzerwa uye dzinonyorwa neelectrocardiograph, uye patani inobuda inonzi electrocardio-gram (ECG). Electrocardiogram yechinyakare inotorwa kubva pamusoro pemuviri, inonzi surface electrocardiogram.
2: Nhoroondo ye tekinoroji ye electrocardiogram
Muna 1887, Waller, purofesa wezvefiziyoloji paMary's Hospital yeRoyal Society of England, akabudirira kunyora nyaya yekutanga ye electrocardiogram yemunhu ne capillary electrometer, kunyangwe mafungu eV1 neV2 e ventricle chete akanyorwa mumufananidzo, uye mafungu eP e atrium haana kunyorwa. Asi basa guru uye rine zvibereko raWaller rakakurudzira Willem Einthoven, uyo aive muvateereri, uye akaisa hwaro hwekuti tekinoroji ye electrocardiogram itange kushanda.
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Kwemakore gumi nematatu akatevera, Einthoven akazvipira zvizere pakudzidza ma electrocardiograms akatorwa nema capillary electrometers. Akavandudza nzira dzakawanda dzinokosha, achishandisa string galvanometer, body surface electrocardiogram yakatorwa paphotosensitive film, akanyora electrocardiogram yakaratidza atrial P wave, ventricular depolarization B, C uye repolarization D wave. Muna 1903, electrocardiograms dzakatanga kushandiswa mukiriniki. Muna 1906, Einthoven akanyora electrocardiograms ye atrial fibrillation, atrial flutter uye ventricular premature beat zvakatevedzana. Muna 1924, Einthoven akapihwa Nobel Prize muMedicine nekuda kwekugadzira kwake electrocardiogram recording.
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3: Kugadzira uye musimboti wehurongwa hwe lead
Muna 1906, Einthoven akakurudzira pfungwa ye "bipolar limb lead". Mushure mekubatanidza maelectrode ekurekodha muruoko rwerudyi, ruoko rweruboshwe negumbo reruboshwe revarwere vari vaviri vaviri, akakwanisa kunyora "bipolar limb lead electrocardiogram" (lead I, lead II nelead III) ine amplitude yakakwira uye yakagadzikana. Muna 1913, "bipolar standard limb conduction electrocardiogram" yakaunzwa zviri pamutemo, uye yakashandiswa yega kwemakore makumi maviri.
Muna 1933, Wilson akazopedzisa kuongorora electrocardiogram yemagetsi, iyo yairatidza nzvimbo ye zero potential uye central electric terminal zvichienderana nemutemo waKirchhoff uripo iye zvino, uye yakagadzira system yeWilson network ine malead gumi nemaviri.
Zvisinei, muhurongwa hwaWilson hwemalead gumi nemaviri, electrocardiogram waveform amplitude ye3 unipolar limb leads VL, VR neVF yakaderera, izvo zvisiri nyore kuyera nekuona shanduko. Muna 1942, Goldberger akaita tsvakiridzo yakawedzerwa, zvichikonzera malead eunipolar pressurized limbs achiri kushandiswa nanhasi: aVL, aVR, uye aVF leads.
Panguva iyi, sisitimu ye12-lead yekurekodha ECG yakatangwa: 3 bipolar limb leads (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar breast leads (V1-V6, Wilson, 1933), uye 3 unipolar compression limb leads (aVL, aVR, aVF, Goldberger, 1942).
4: Maitiro ekuwana chiratidzo cheECG chakanaka
1. Kugadzirira ganda. Sezvo ganda risingafambi zvakanaka, kurapwa kwakakodzera kweganda remurwere panzvimbo dzakaiswa maerekitirodhi kwakakosha kuti uwane masaini emagetsi eECG akanaka. Sarudza akati sandara ane tsandanyama shoma.
Ganda rinofanira kurapwa nenzira dzinotevera: ① Bvisa bvudzi remuviri panowanikwa electrode. Kwiza ganda zvinyoro nyoro panowanikwa electrode kubvisa masero eganda akafa. ③ Geza ganda zvakanaka nemvura ine sipo (usashandise ether nedoro yakachena, nekuti izvi zvinowedzera simba reganda). ④ Rega ganda riome zvachose usati waisa electrode. ⑤ Isa ma clamp kana mabhatani usati waisa ma electrode pamurwere.
2. Nyatsoteerera kugadziriswa kwewaya inofambisa mweya, rambidza kumonera nekusunga waya yemutobvu, dzivirira jira rekudzivirira waya yemutobvu kuti isakuvara, uye chenesa tsvina iri pabhodhi remutobvu kana bhandi panguva yakakodzera kudzivirira kuoxidation yemutobvu.
Nguva yekutumira: Gumiguru-12-2023
