Nkibikoresho bikunze kugaragara mubikorwa byubuvuzi, moniteur yibice byinshi byumurwayi ni ubwoko bwibimenyetso byibinyabuzima kumara igihe kirekire, ibipimo byinshi byerekana imiterere ya physiologique na patologi y’abarwayi ku barwayi bakomeye, kandi binyuze mu gihe nyacyo kandi cyikora cyo gusesengura no gutunganya , guhinduka mugihe cyamakuru agaragara, gutabaza byikora no gufata amajwi byikora bishobora guhitana ubuzima. Usibye gupima no gukurikirana ibipimo ngororamubiri by’abarwayi, irashobora kandi gukurikirana no guhangana n’imiterere y’abarwayi mbere na nyuma y’imiti no kubagwa, kuvumbura ku gihe impinduka z’imiterere y’abarwayi barembye cyane, kandi bigatanga ishingiro ry’abaganga kuri gusuzuma neza no gutegura gahunda zubuvuzi, bityo bikagabanya cyane impfu zabarwayi barembye cyane.
Hamwe niterambere ryikoranabuhanga, ibintu byo kugenzura ibintu byinshi bikurikirana abarwayi barushijeho kwaguka bava mumikorere yimikorere yubuhumekero, nervous, metabolic nubundi buryo.Module kandi yaguwe kuva module isanzwe ikoreshwa na ECG (ECG), module yubuhumekero (RESP), module yuzuye ya ogisijeni yamaraso (SpO2), module yumuvuduko wamaraso (NIBP) kugeza module yubushyuhe (TEMP), module yumuvuduko wamaraso (IBP) , module yimura umutima (CO), module idahwitse ikomeza kwimura umutima (ICG), hamwe na module ya karuboni ya dioxyde de moderi (EtCO2)), module ya electroencephalogram module (EEG), module yo gukurikirana gazi ya anesteziya (AG), module yo gukurikirana gazi ya transitane, anesthesia module ikurikirana byimbitse (BIS), module yo kugenzura imitsi yoroheje (NMT), module ikurikirana hemodinamike (PiCCO), module yubuhumekero.
Ibikurikira, bizagabanywamo ibice byinshi kugirango tumenye ishingiro ryimiterere, ihame, iterambere no gushyira mubikorwa buri cyiciro.Reka duhere kuri module ya electrocardiogram (ECG).
1 mechanism Uburyo bwo gukora amashanyarazi
Cardiomyocytes ikwirakwizwa muri sinus node, ihuriro rya atrioventricular, inzira ya atrioventricular n'amashami yacyo bitanga ibikorwa byamashanyarazi mugihe cyo kwishima kandi bikabyara amashanyarazi mumubiri. Gushyira icyuma cya electrode yicyuma muri uyu murima wamashanyarazi (ahantu hose mumubiri) birashobora kwandika imbaraga zidafite imbaraga. Umuriro w'amashanyarazi uhinduka ubudahwema igihe cyigihe cyo kugenda.
Kubera imiterere itandukanye yamashanyarazi yingirangingo nibice bitandukanye byumubiri, ubushakashatsi bwa electrode mubice bitandukanye byanditseho impinduka zitandukanye muri buri cyiciro cyumutima. Izi mpinduka ntoya zishobora kwongerwaho no kwandikwa na electrocardiograf, kandi ibisubizo bivamo byitwa electrocardio-gram (ECG). Imashanyarazi gakondo yandikwa hejuru yumubiri, bita hejuru ya electrocardiogram.
2 ： Amateka yubuhanga bwa electrocardiogram
Mu 1887, Waller, umwarimu w’imyororokere mu bitaro bya Mariya by’Umuryango w’Umwami w’Ubwongereza, yanditse neza ikibazo cya mbere cy’amashanyarazi ya electrocardiogramu y’umuntu hamwe na electrometero ya capillary, nubwo kuri iyi shusho, V1 na V2 gusa by’umuyaga byanditse kuri iyo shusho, hamwe n’umuraba wa P ntibyanditswe. Ariko ibikorwa bikomeye bya Waller kandi byera imbuto byatumye Willem Einthoven wari mu bari bateraniye aho, ashyiraho urufatiro rwo gutangiza ikoranabuhanga rya electrocardiogram.
------------------------ （AugustusDisire Walle） ---------------------- ----------------- （Waller yanditse amashanyarazi ya mbere yumuntu） ------------------------- ------------------------ （Capillary electrometero） -----------
Mu myaka 13 yakurikiyeho, Einthoven yitangiye rwose kwiga amashanyarazi ya electrocardiogramu yanditswe na capillary electrometero. Yateje imbere tekinike nyinshi zingenzi, akoresha neza umugozi wa galvanometero, hejuru yumubiri wa electrocardiogram yanditswe kuri firime yifotora, yandika electrocardiogramu yerekana umuyaga wa P, umuyaga wa depolarisiyasi B, C na repolarisation D. Mu 1903, amashanyarazi ya electrocardiogramu yatangiye gukoreshwa mubuvuzi. Mu 1906, Einthoven yanditse amashanyarazi ya electrocardiogramu ya fibrillation atriel, flutter atrial na ventricular imburagihe yakurikiranye. Mu 1924, Einthoven yahawe igihembo cyitiriwe Nobel mu buvuzi kubera ko yahimbye amashusho ya electrocardiogram.
------------------------------------------------ ------------------------------------- True electrocardiogram yuzuye yanditswe na Einthoven ------- ------------------------------------------------ -------------------------------------------------
3 Iterambere nihame rya sisitemu yo kuyobora
Mu 1906, Einthoven yatanze igitekerezo cyo kuyobora bipolar. Amaze guhuza electrode yafashwe mu kuboko kw'iburyo, ukuboko kw'ibumoso n'ukuguru kw'ibumoso by'abarwayi ari babiri, yashoboraga kwandika bipolar limb lead lead electrocardiogram (lead I, lead II na lead III) hamwe na amplitude kandi ifite ishusho ihamye. Mu 1913, hatangijwe kumugaragaro bipolar isanzwe yo gutwara ingingo ya electrocardiogram, kandi yakoreshejwe wenyine mumyaka 20.
Mu 1933, Wilson yarangije kurangiza amashanyarazi ya unipolar electrocardiogram, yagennye aho ubushobozi bwa zeru hamwe n’umuriro w'amashanyarazi hagati ukurikije amategeko ya Kirchhoff asanzweho, anashyiraho sisitemu 12 iyobora umuyoboro wa Wilson.
Nyamara, muri sisitemu ya 12 ya Wilson, amashanyarazi ya electrocardiogramu amplitude yingingo 3 unipolar iganisha VL, VR na VF iri hasi, ntabwo byoroshye gupima no kureba impinduka. Mu 1942, Goldberger yakoze ubundi bushakashatsi, bituma ingingo ya unipolar yotswa igitutu ikomeza gukoreshwa muri iki gihe: aVL, aVR, na aVF iyobora.
Kuri ubu, hashyizweho uburyo busanzwe bwa 12-buyobora gufata amajwi ECG: hashyizweho ingingo 3 za bipolar (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), amabere 6 ya unipolar (V1-V6, Wilson, 1933), hamwe no kwikuramo 3 unipolar ingingo iyobora (aVL, aVR, aVF, Goldberger, 1942).
4 ： Nigute ushobora kubona ibimenyetso byiza bya ECG
1. Gutegura uruhu. Kubera ko uruhu ari umuyoboro mubi, kuvura neza uruhu rwumurwayi aho electrode zishyirwa birakenewe kugirango ubone ibimenyetso byamashanyarazi bya ECG. Hitamo ibinini bifite imitsi mike
Uruhu rugomba kuvurwa ukurikije uburyo bukurikira: ① Kuraho umusatsi wumubiri aho electrode ishyizwe. Koresha buhoro buhoro uruhu aho electrode ishyizwe kugirango ukureho selile zuruhu zapfuye. ③ Koza uruhu neza n'amazi yisabune (ntukoreshe ether na alcool nziza, kuko ibi bizongera imbaraga zuruhu). Emera uruhu rwumuke rwose mbere yo gushyira electrode. Shyira clamp cyangwa buto mbere yo gushyira electrode kumurwayi.
2. Witondere kubungabunga insinga zitwara umutima, kubuza guhindagura no gupfundika insinga ziyobora, wirinde urwego rukingira insinga ziyobora kwangirika, kandi usukure mugihe umwanda uri kuri clip cyangwa indobo kugirango wirinde okiside.
Igihe cyo kohereza: Ukwakira-12-2023
