ʻOiai ʻo ia ka mea hana maʻamau i ka hana lapaʻau, ʻo ka mea nānā maʻi multi-parameter he ʻano hōʻailona olaola no ka ʻike lōʻihi, multi-parameter o ke kūlana physiological a me ka pathological o nā maʻi i nā maʻi koʻikoʻi, a ma o ka nānā ʻana a me ka hana ʻakomi manawa maoli, ka hoʻololi manawa kūpono i ka ʻike ʻike maka, ka alarm aunoa a me ka hoʻopaʻa ʻakomi o nā hanana hoʻoweliweli ola. Ma waho aʻe o ke ana ʻana a me ka nānā ʻana i nā palena physiological o nā maʻi, hiki iā ia ke nānā a hana me ke kūlana o nā maʻi ma mua a ma hope o ka lāʻau lapaʻau a me ke ʻoki ʻana, ʻike i nā loli i ke kūlana o nā maʻi maʻi koʻikoʻi i ka manawa kūpono, a hāʻawi i kahi kumu kumu no nā kauka e ʻike pololei a hoʻolālā i nā hoʻolālā lapaʻau, a pēlā e hōʻemi nui ai i ka make o nā maʻi maʻi koʻikoʻi.
Me ka hoʻomohala ʻana o ka ʻenehana, ua hoʻonui ʻia nā mea nānā o nā mea nānā maʻi multi-parameter mai ka ʻōnaehana kahe koko i ka ʻōnaehana hanu, ka hopohopo, ka metabolic a me nā ʻōnaehana ʻē aʻe.Ua hoʻonui ʻia hoʻi ka module mai ka module ECG (ECG) i hoʻohana pinepine ʻia, ka module hanu (RESP), ka module saturation oxygen koko (SpO2), ka module kaomi koko ʻole (NIBP) i ka module mahana (TEMP), ka module kaomi koko ʻole (IBP), ka module neʻe ʻana o ka puʻuwai (CO), ka module neʻe ʻana o ka puʻuwai mau ʻole (ICG), a me ka module carbon dioxide hope-hanu (EtCO2) ), ka module nānā electroencephalogram (EEG), ka module nānā kinoea anesthesia (AG), ka module nānā kinoea transcutaneous, ka module nānā hohonu anesthesia (BIS), ka module nānā hoʻomaha ʻiʻo (NMT), ka module nānā hemodynamics (PiCCO), ka module mechanics hanu.
ʻO ka mea aʻe, e māhele ʻia i kekahi mau ʻāpana e hoʻolauna i ke kumu physiological, ke kumumanaʻo, ka hoʻomohala ʻana a me ka hoʻohana ʻana o kēlā me kēia module.E hoʻomaka kākou me ka module electrocardiogram (ECG).
1: Ke ʻano hana o ka hana ʻana o ka electrocardiogram
ʻO nā cardiomyocytes i hoʻolaha ʻia ma ka sinus node, atrioventricular junction, atrioventricular tract a me kona mau lālā e hoʻoulu i ka hana uila i ka wā o ka hoʻonāukiuki a hoʻoulu i nā kahua uila i loko o ke kino. ʻO ke kau ʻana i kahi electrode probe metala i loko o kēia kahua uila (ma nā wahi āpau o ke kino) hiki ke hoʻopaʻa i kahi au nāwaliwali. Hoʻololi mau ke kahua uila i ka wā e loli ai ka wā o ka neʻe ʻana.
Ma muli o nā ʻano uila like ʻole o nā ʻiʻo a me nā ʻāpana like ʻole o ke kino, ua hoʻopaʻa nā electrodes ʻimi ma nā ʻāpana like ʻole i nā loli hiki ke hana ʻia i kēlā me kēia pōʻaiapuni cardiac. Hoʻonui ʻia kēia mau loli hiki ke hana ʻia a hoʻopaʻa ʻia e kahi electrocardiograph, a ua kapa ʻia ke ʻano hopena he electrocardio-gram (ECG). Hoʻopaʻa ʻia ka electrocardiogram kuʻuna mai ka ʻili o ke kino, i kapa ʻia ʻo ka electrocardiogram ʻili.
2：Mōʻaukala o ka ʻenehana electrocardiogram
I ka makahiki 1887, ua hoʻopaʻa pono ʻo Waller, ke polopeka o ka physiology ma ka Halemai ʻo Mary o ka Royal Society of England, i ka hihia mua o ka electrocardiogram kanaka me kahi electrometer capillary, ʻoiai ʻo nā nalu V1 a me V2 wale nō o ka ventricle i hoʻopaʻa ʻia ma ke kiʻi, a ʻaʻole i hoʻopaʻa ʻia nā nalu atrial P. Akā, ua hoʻoikaika ka hana nui a hua nui a Waller iā Willem Einthoven, ka mea i loko o ka lehulehu, a ua hoʻokumu i ke kahua no ka hoʻolauna hope ʻana o ka ʻenehana electrocardiogram.
------------------------（AugustusDisire Walle）----------------------------------------（Ua hoʻopaʻa ʻo Waller i ka electrocardiogram kanaka mua）------------------------------------------------（Capillary electrometer）------------
No nā makahiki he 13 e hiki mai ana, ua hoʻolaʻa piha ʻo Einthoven iā ia iho i ke aʻo ʻana i nā electrocardiograms i hoʻopaʻa ʻia e nā electrometers capillary. Ua hoʻomaikaʻi ʻo ia i kekahi mau ʻano hana koʻikoʻi, me ka hoʻohana pono ʻana i ka galvanometer kaula, ka electrocardiogram ʻili kino i hoʻopaʻa ʻia ma ke kiʻiʻoniʻoni photosensitive, ua hoʻopaʻa ʻo ia i ka electrocardiogram i hōʻike i ka nalu atrial P, ka ventricular depolarization B, C a me ka nalu repolarization D. I ka makahiki 1903, ua hoʻomaka ka hoʻohana ʻana i nā electrocardiograms ma ke ʻano lapaʻau. I ka makahiki 1906, ua hoʻopaʻa ʻo Einthoven i nā electrocardiograms o ka atrial fibrillation, atrial flutter a me ka ventricular premature beat. I ka makahiki 1924, ua hāʻawi ʻia ʻo Einthoven i ka Nobel Prize in Medicine no kāna hana ʻana i ka hoʻopaʻa ʻana i ka electrocardiogram.
--------------------------------------------------------------------------------------------------------ʻO ka electrocardiogram piha maoli i hoʻopaʻa ʻia e Einthoven--------------------------------------------------------------------------------------------------------------------------
3：Ka hoʻomohala ʻana a me ke kumumanaʻo o ka ʻōnaehana alakaʻi
I ka makahiki 1906, ua hāpai ʻo Einthoven i ke kumumanaʻo o ke alakaʻi lālā bipolar. Ma hope o ka hoʻopili ʻana i nā electrodes hoʻopaʻa leo ma ka lima ʻākau, ka lima hema a me ka wāwae hema o nā maʻi ma nā pālua, hiki iā ia ke hoʻopaʻa i ka electrocardiogram alakaʻi lālā bipolar (alakaʻi I, alakaʻi II a me ke alakaʻi III) me ka amplitude kiʻekiʻe a me ke ʻano paʻa. I ka makahiki 1913, ua hoʻolauna kūhelu ʻia ka electrocardiogram alakaʻi lālā bipolar maʻamau, a ua hoʻohana wale ʻia no 20 mau makahiki.
I ka makahiki 1933, ua hoʻopau hope ʻo Wilson i ka electrocardiogram alakaʻi unipolar, ka mea i hoʻoholo i ke kūlana o ka hiki ʻole a me ke kikowaena uila waena e like me ke kānāwai o Kirchhoff i kēia manawa, a hoʻokumu i ka ʻōnaehana 12-alakaʻi o ka pūnaewele Wilson.
Eia nō naʻe, ma ka ʻōnaehana 12-alakaʻi a Wilson, haʻahaʻa ka amplitude waveform electrocardiogram o nā alakaʻi lālā unipolar 3 ʻo VL, VR a me VF, ʻaʻole maʻalahi ke ana a nānā i nā loli. I ka makahiki 1942, ua hana ʻo Goldberger i kahi noiʻi hou aku, a ua hopena i nā alakaʻi lālā pressurized unipolar e hoʻohana mau ʻia nei i kēia lā: aVL, aVR, a me nā alakaʻi aVF.
I kēia manawa, ua hoʻolauna ʻia ka ʻōnaehana 12-alakaʻi maʻamau no ka hoʻopaʻa ʻana i ka ECG: 3 mau alakaʻi lālā bipolar (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 mau alakaʻi umauma unipolar (V1-V6, Wilson, 1933), a me 3 mau alakaʻi lālā compression unipolar (aVL, aVR, aVF, Goldberger, 1942).
4：Pehea e loaʻa ai ka hōʻailona ECG maikaʻi
1. Hoʻomākaukau ʻili. ʻOiai he alakaʻi maikaʻi ʻole ka ʻili, pono ka mālama pono ʻana i ka ʻili o ka mea maʻi kahi i kau ʻia ai nā electrodes e loaʻa ai nā hōʻailona uila ECG maikaʻi. E koho i nā mea pālahalaha me ka ʻiʻo liʻiliʻi.
Pono e mālama ʻia ka ʻili e like me kēia mau ʻano hana: ① Wehe i ka lauoho o ke kino kahi i waiho ʻia ai ka electrode. E hamo mālie i ka ʻili kahi i waiho ʻia ai ka electrode e wehe i nā ʻili make. ③ E holoi pono i ka ʻili me ka wai kopa (mai hoʻohana i ka ether a me ka waiʻona maʻemaʻe, no ka mea e hoʻonui kēia i ke kūpaʻa o ka ʻili). ④ E ʻae i ka ʻili e maloʻo loa ma mua o ke kau ʻana i ka electrode. ⑤ E hoʻokomo i nā clamps a i ʻole nā pihi ma mua o ke kau ʻana i nā electrodes ma luna o ka mea maʻi.
2. E makaʻala i ka mālama ʻana i ke kaula conductance cardiac, e pāpā i ka wili ʻana a me ke nakinaki ʻana i ke kaula alakaʻi, e pale i ka papa pale o ke kaula alakaʻi mai ka hōʻino ʻia, a e hoʻomaʻemaʻe i ka lepo ma ke clip alakaʻi a i ʻole ka buckle i ka manawa kūpono e pale aku ai i ka oxidation alakaʻi.
Ka manawa hoʻouna: ʻOkakopa-12-2023
