Nk'ibikoresho bikunze gukoreshwa mu buvuzi, icyuma gipima abarwayi gifite ibipimo byinshi ni ubwoko bw'ikimenyetso cy'ibinyabuzima cyo kumenya igihe kirekire imiterere y'umubiri n'indwara z'abarwayi mu barwayi barembye, no binyuze mu isesengura no gutunganya mu buryo bwihuse, guhindura amakuru ku gihe, gutanga amakuru y'inyuma no gufata amashusho mu buryo bwihuse ibintu bishobora gushyira ubuzima mu kaga. Uretse gupima no gukurikirana ibipimo by'umubiri by'abarwayi, gishobora kandi gukurikirana no guhangana n'imiterere y'abarwayi mbere na nyuma yo gufata imiti no kubagwa, kuvumbura impinduka mu miterere y'abarwayi barembye cyane, no gutanga ishingiro ry'ibanze ku baganga ryo gusuzuma no gushyiraho gahunda z'ubuvuzi neza, bityo bikagabanya cyane impfu z'abarwayi barembye cyane.
Bitewe n'iterambere ry'ikoranabuhanga, ibikoresho byo gukurikirana by'abarwayi bifite ibipimo byinshi byagiye bikura biva ku mikorere y'amaraso bikagera ku mikorere y'ubuhumekero, iy'ubwonko, iy'imikorere y'umubiri n'izindi.Iyi module kandi yaguwe kuva kuri module ikoreshwa cyane ya ECG (ECG), module yo guhumeka (RESP), module yo gusana ogisijeni mu maraso (SpO2), module yo kudatera mu maraso (NIBP) kugeza kuri module yo gushyuha (TEMP), module yo kudatera mu maraso (IBP), module yo gutatanya umutima (CO), module yo kudatera mu maraso ikomeza gutatanya umutima (ICG), na module yo gusohora umwuka wa karuboni (EtCO2)), module yo gukurikirana electroencephalogram (EEG), module yo gukurikirana imyuka itera mu maraso (AG), module yo gukurikirana imyuka itera mu maraso, module yo kugenzura ubujyakuzimu bw'ikinya (BIS), module yo gukurikirana imitsi iruhuka (NMT), module yo gukurikirana hemodynamics (PiCCO), module yo kugenzura uburyo bwo guhumeka.
Hanyuma, izagabanywamo ibice byinshi kugira ngo itangire ishingiro ry’imikorere y’umubiri, ihame, iterambere n’ishyirwa mu bikorwa rya buri module.Reka dutangire na module ya electrocardiogram (ECG).
1: Uburyo bwo gukora electrocardiogram
Imitsi y'umutima ikwirakwira mu gice cy'inyuma cy'amaraso, mu gice cy'inyuma cy'amaraso, mu nzira y'amaraso ya atrioventricular no mu mashami yayo bitanga amashanyarazi mu gihe cyo gushyuha no mu gukora amashanyarazi mu mubiri. Gushyira electrode y'icyuma muri uyu murima w'amashanyarazi (aho ari ho hose mu mubiri) bishobora kwandika umuvuduko w'amashanyarazi udakomeye. Umuvuduko w'amashanyarazi uhora uhinduka uko igihe cyo kugenda gihinduka.
Bitewe n'imiterere itandukanye y'amashanyarazi y'ingingo n'ibice bitandukanye by'umubiri, electrode zo gushakisha mu bice bitandukanye zanditse impinduka zitandukanye zishobora kubaho muri buri ruziga rw'umutima. Izi mpinduka nto zishobora kubaho zongerwa kandi zigafatwa hakoreshejwe electrocardiograph, kandi imiterere ikomokaho yitwa electrocardiogram (ECG). Electrocardiogram isanzwe ifatwa uhereye ku buso bw'umubiri, yitwa electrocardiogram yo hejuru.
2: Amateka y'ikoranabuhanga rya electrocardiogram
Mu 1887, Waller, umwarimu w’ubuvuzi bw’umubiri mu bitaro bya Mary's bya Royal Society of England, yafashe neza electrocardiogram ya mbere y’umuntu akoresheje electrometer ya capillary, nubwo imiraba ya V1 na V2 gusa ya ventricle yanditswe muri iyo shusho, kandi imiraba ya P ya atrium ntiyanditswe. Ariko akazi ka Waller gakomeye kandi keza katumye Willem Einthoven, wari mu bitabiriye, ashyiraho urufatiro rw’ikoranabuhanga rya electrocardiogram.
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Mu myaka 13 yakurikiyeho, Einthoven yiyeguriye kwiga electrocardiograms zafashwe na electrometers za capillary. Yanogeje ubuhanga bwinshi bw'ingenzi, akoresha neza galvanometer y'imigozi, electrocardiogram y'umubiri yafashwe kuri filime ifasha umuntu kubona amashusho, yafashe electrocardiogram yerekanaga umuraba wa P w'atrial, ventricular depolarization B, C na repolarization D wave. Mu 1903, electrocardiograms zatangiye gukoreshwa mu buvuzi. Mu 1906, Einthoven yanditse electrocardiograms za atrial fibrillation, atrial flutter na ventricular beat itaragera buhoro buhoro. Mu 1924, Einthoven yahawe igihembo cya Nobel mu buvuzi kubera kuvumbura electrocardiogram recordings.
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3: Iterambere n'amahame ya sisitemu y'ubutare
Mu 1906, Einthoven yatanze igitekerezo cy’uburyo bwo gufata icyuma gipima amaguru. Nyuma yo guhuza electrode zo gufata amashusho mu kuboko kw’iburyo, ku kuboko kw’ibumoso no ku kuguru kw’ibumoso kw’abarwayi babiri babiri, yashoboraga gufata electrocardiogram y’umutima (lead I, lead II na lead III) ifite amplitude nyinshi kandi ihamye. Mu 1913, electrocardiogram ikoresha icyuma gipima amaguru gipima amaguru gikoresha icyuma ...
Mu 1933, Wilson yarangije gukora electrocardiogram y’umutima ipima amashanyarazi mu buryo bungana, yagennye aho amashanyarazi aherereye hashingiwe ku itegeko rya Kirchhoff ririho ubu, kandi ishyiraho sisitemu y’amashanyarazi ipima amashanyarazi 12.
Ariko, muri sisitemu ya Wilson ifite amashami 12, uburebure bw'umuraba wa electrocardiogram bw'imirongo itatu ya VL, VR na VF ni buke, ibyo bikaba bigoye kubipima no kubona impinduka. Mu 1942, Goldberger yakoze ubushakashatsi bwiyongereyeho, bituma habaho amashami ya amashami ya 12 yashyizwemo umuvuduko udasanzwe aracyakoreshwa na n'ubu: aVL, aVR, na aVF.
Muri iki gihe, sisitemu isanzwe ya 12-leads yo kwandika ECG yatangijwe: 3 bipolar limb leads (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar breast leads (V1-V6, Wilson, 1933), na 3 unipolar compression limb leads (aVL, aVR, aVF, Goldberger, 1942).
4: Uburyo bwo kubona ikimenyetso cyiza cya ECG
1. Gutegura uruhu. Kubera ko uruhu rudakora neza, ni ngombwa gufata neza uruhu rw'umurwayi aho electrodes zishyirwa kugira ngo haboneke ibimenyetso byiza by'amashanyarazi bya ECG. Hitamo izifite imitsi mike.
Uruhu rugomba kuvurwa hakurikijwe uburyo bukurikira: ① Kuraho ubwoya bw'umubiri aho electrode ishyizwe. Siga witonze uruhu aho electrode ishyizwe kugira ngo ukureho uturemangingo tw'uruhu twapfuye. ③ Oza uruhu neza n'amazi y'isabune (ntugakoreshe ether na alcool nziza, kuko ibi byongera imbaraga z'uruhu). ④ Reka uruhu rwumuke burundu mbere yo gushyira electrode. ⑤ Shyiraho udupfukamunwa cyangwa utubuto mbere yo gushyira electrode ku murwayi.
2. Itondere kubungabunga insinga iyobora umutima, buza gufunga no gupfundika insinga y'icyuma, wirinde ko urwego rw'uburinzi bw'icyuma cy'icyuma cyangirika, kandi usukure ku gihe umwanda uri ku gice cy'icyuma cy'icyuma cyabigenewe cyangwa ku gipfunyika kugira ngo hirindwe ko icyuma cy'icyuma cyangirika.
Igihe cyo kohereza: Ukwakira-12-2023
