E like me ka mea maʻamau lako i loko o ka lapaʻau hoʻomaʻamaʻa, multi-parameter kanaka kiaʻi mea he 'ano o ka biological hōʻailona no ka lōʻihi, multi-parameter ike o physiological a me ka pathological kūlana o nā maʻi i loko o koʻikoʻi nā maʻi, a ma o ka manawa maoli a me ka 'akomi ana a me ka hana ana, ka manawa hoololi i ka ike ike, 'akomi alarm a me ka 'akomi hoʻopaʻa 'ana o nā hanana hiki ke ola. Ma waho aʻe o ke ana ʻana a me ka nānā ʻana i nā ʻāpana physiological o nā maʻi, hiki iā ia ke nānā a hoʻoponopono i ke kūlana o nā mea maʻi ma mua a ma hope o ka lāʻau lapaʻau a me ka ʻoki ʻana, e ʻike i ka manawa kūpono i nā loli i ke kūlana o nā maʻi maʻi koʻikoʻi, a hāʻawi i kumu kumu no nā kauka e hoʻomaʻamaʻa pololei a hoʻolālā i nā hoʻolālā olakino, 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 maʻi maʻi multi-parameter mai ka ʻōnaehana circulatory i ka hanu, hopohopo, metabolic a me nā ʻōnaehana ʻē aʻe.Hoʻonui ʻia ka module mai ka module ECG maʻamau (ECG), module respiratory (RESP), module saturation oxygen koko (SpO2), module noninvasive blood pressure (NIBP) i ka module wela (TEMP), invasive blood pressure module (IBP), cardiac displacement module (CO), noninvasive continue cardiac displacement module (ICG), a me end-breath carbon displacement module (ICG), a me ka end-breath carbon dioxide module (EEG), ke kinoea hoʻomaʻemaʻe kino (AG), transcutaneous kinoea kiaʻi module, anesthesia hohonu ka nānā 'ana module (BIS), muscle hoʻomaha hoʻomaha modula (NMT), hemodynamics nānā module (PiCCO), hanu mechanics module.
A laila, e māhele ʻia i mau ʻāpana e hoʻolauna i ke kumu physiological, kumu, hoʻomohala a me ka hoʻohana ʻana i kēlā me kēia module.E hoʻomaka kākou me ka module electrocardiogram (ECG).
1: ʻO ke ʻano o ka hana electrocardiogram
Hoʻokaʻawale ʻia nā Cardiomyocytes i loko o ka sinus node, atrioventricular junction, atrioventricular tract a me kāna mau lālā e hoʻoulu i ka hana uila i ka wā hauʻoli a hoʻoulu i nā māla uila i ke kino. Hiki ke hoʻopaʻa i kahi ʻāwīwī nāwaliwali ke kau ʻana i kahi electrode probe metala ma kēia kahua uila (ma nā wahi āpau o ke kino). Hoʻololi mau ke kahua uila e like me ka loli ʻana o ka manawa o ka neʻe.
Ma muli o nā ʻano uila like ʻole o nā ʻiʻo a me nā ʻāpana like ʻole o ke kino, ua hoʻopaʻa ʻia nā electrodes ʻimi ma nā ʻāpana like ʻole i nā loli like ʻole i kēlā me kēia pōʻai cardiac. Hoʻonui ʻia kēia mau hoʻololi liʻiliʻi liʻiliʻi a hoʻopaʻa ʻia e kahi electrocardiograph, a ua kapa ʻia ke kumu hopena he electrocardio-gram (ECG). Hoʻopaʻa ʻia ka electrocardiogram kuʻuna mai ka ʻili o ke kino, i kapa ʻia ʻo ka electrocardiogram surface.
2: Ka moʻolelo o ka ʻenehana electrocardiogram
I ka makahiki 1887, ua hoʻopaʻa maikaʻi ʻo Waller, ke kaukaʻi o ka physiology ma Mary's Hospital o ka Royal Society of England, i ka hihia mua o ka electrocardiogram kanaka me ka electrometer capillary, ʻoiai ʻo V1 a me V2 wale nō o ka ventricle i hoʻopaʻa ʻia ma ke kiʻi, a ʻaʻole i kākau ʻia nā hawewe P atrial. Akā ʻo ka hana nui a me ka hua o Waller ua hoʻoikaika ʻo Willem Einthoven, ka mea i loko o ka lehulehu, a ua kau i ke kumu no ka hoʻomaka ʻana o ka ʻenehana electrocardiogram.
-------------------------（AugustusDisire Walle）--------------------------------------（Waller i hoʻopaʻa i ka electrocardiogram kanaka mua）------------------------------------------------（Cpillary electrometer ）-----------
No nā makahiki he 13 e hiki mai ana, ua hāʻawi ʻo Einthoven iā ia iho i ke aʻo ʻana i nā electrocardiograms i hoʻopaʻa ʻia e nā electrometers capillary. Ua hoʻomaikaʻi ʻo ia i nā ʻano kī nui, me ka hoʻohana pono ʻana i ke kaula galvanometer, ka electrocardiogram ili kino i hoʻopaʻa ʻia ma ke kiʻi photosensitive, ua hoʻopaʻa ʻo ia i ka electrocardiogram i hōʻike i ka hawewe P atrial, ventricular depolarization B, C a me repolarization D hawewe. I ka makahiki 1903, hoʻomaka ka hoʻohana ʻana i nā electrocardiograms. I ka makahiki 1906, ua hoʻopaʻa ʻo Einthoven i nā electrocardiograms o ka atrial fibrillation, atrial flutter a me ka ventricular premature beat successively. 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.
------------------------------------------------------------------------------------ʻOiaʻiʻo electrocardiogram piha i hoʻopaʻa ʻia e Einthoven -------------------------------------------------------------------------------------------------------------------
3: Hoʻomohala a me ke kumu o ka ʻōnaehana alakaʻi
I ka makahiki 1906, ua hāpai ʻo Einthoven i ka manaʻo o ke alakaʻi lālā bipolar. Ma hope o ka hoʻohui ʻana i nā electrodes ma ka lima ʻākau, ka lima hema a me ka wāwae hema o nā mea maʻi i ʻelua, hiki iā ia ke hoʻopaʻa i ka bipolar limb lead electrocardiogram (lead I, lead II a me ke alakaʻi III) me ka amplitude kiʻekiʻe a me ke ʻano paʻa. I ka makahiki 1913, ua hoʻolauna mua ʻia ka bipolar standard limb conduction electrocardiogram, a ua hoʻohana wale ʻia no 20 mau makahiki.
I ka makahiki 1933, ua hoʻopau hope ʻo Wilson i ka unipolar lead electrocardiogram, nāna i hoʻoholo i ke kūlana o ka zero potential a me ke kikowaena uila e like me ke kānāwai o Kirchhoff i kēia manawa, a hoʻokumu i ka ʻōnaehana 12-lead o ka pūnaewele Wilson.
Eia nō naʻe, ma ka ʻōnaehana 12-lead a Wilson, ʻo ka electrocardiogram waveform amplitude o ka lālā unipolar 3 alakaʻi iā VL, VR a me VF haʻahaʻa, ʻaʻole maʻalahi ke ana a nānā i nā loli. I ka makahiki 1942, ua alakaʻi hou ʻo Goldberger i ka noiʻi hou ʻana, i hopena i ke alakaʻi unipolar pressurized limb e hoʻohana mau nei i kēia lā: aVL, aVR, a me aVF alakaʻi.
I kēia manawa, ua hoʻokomo ʻia ka ʻōnaehana 12-lead maʻamau no ka hoʻopaʻa ʻana i ka ECG: 3 bipolar limb alakaʻi (Ⅰ, Ⅱ, Ⅲ, Einthoven, 1913), 6 unipolar umauma alakaʻi (V1-V6, Wilson, 1933), a me 3 unipolar compression limb alakaʻi aVR, aVL, 4F, Gold, aVL.
4: Pehea e loaʻa ai ka hōʻailona ECG maikaʻi
1. Hoʻomākaukau ʻili. No ka mea he conductor 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 palahalaha me ka liʻiliʻi o ka ʻiʻo
Pono e mālama ʻia ka ʻili e like me kēia: ① Wehe i ka lauoho kino kahi i kau ʻia ai ka electrode. E hamo mālie i ka ʻili kahi i kau ʻia ai ka electrode e wehe i nā ʻili 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 pipili a i ʻole nā pihi ma mua o ka kau ʻana i nā electrodes ma luna o ka mea maʻi.
2. E hoʻolohe i ka mālama ʻana i ka uwea conductance cardiac, pāpā i ka wili ʻana a me ka hoʻopaʻa ʻana i ka uea kepau, e pale i ka pale o ka uea kepau mai ka pōʻino, a hoʻomaʻemaʻe pono i ka lepo ma ka pahu alakaʻi a i ʻole ka pahu e pale ai i ka oxidation kepau.
Ka manawa hoʻouna: ʻOkakopa-12-2023
