Phunzirani Zambiri Pamutu Wathu wa ECG wosawonongeka
Ngati mwalangizidwa ndi dokotala kuti muli ndi mtolo wa nthambi, zikutanthauza kuti electrocardiogram (ECG) yanu ikuwonetseratu njira yosiyana, yodabwitsa. M'nkhani ino tidzakambirana za zomwe nthambi yamatabwa imatanthauza, ndi mafunso ati omwe mungafunse dokotala wanu.
Ndondomeko Yomangamanga Yachilengedwe Yamakono
Nthambizi ndi mbali yofunikira ya magetsi a mtima , dongosolo lomwe limayendetsa mtima wamtima ndikugwirizanitsa zochita za mtima.
Mtima umagunda pomvera chizindikiro cha magetsi. Pamene chizindikiro cha magetsi chikugawidwa mu mtima wonse, zimagwirizanitsa mtima. Choncho kupatsana bwino kwa nthawi yamagetsi ndi kofunika kwambiri kuti ntchitoyi ikhale yogwira bwino.
Chizindikiro cha magetsi cha mtima chimachokera mu node ya sinus kumtunda wa pamwamba pa atrium, imafalikira pa aria onse awiri (kuchititsa atria kumenya), ndiyeno kudutsa muzithunzi za AV . Kusiya nthenda ya AV, magetsi amalowetsa m'makutu a mpweya kudzera m'magulu a mtima wamtundu wotchedwa Bundle Wake. Kuchokera ku mtolo wake, magetsi amalowa m'magulu awiri a mtolo: nthambi yoyenera ndi nthambi ya kumanzere. Nthambi zamanja ndi zamanzere zimagwiritsira ntchito magetsi pamagulu olowera kumanja ndi kumanzere, motero amawapanga. Pamene nthambi za mtolo zimagwira ntchito moyenera, ma ventricles abwino ndi omanzere amagwirizana pafupifupi nthawi yomweyo.
ECG ndizowonetseratu mphamvu ya magetsi pamene ikudutsa pamtima. Zambiri za QRS ndi zomwe akatswiri a mtima amazitcha mbali ina ya ECG, gawo lomwe limasonyeza mphamvu ya magetsi ngati ikugawidwa ndi nthambi yamagetsi muzitsulo zonse.
Pachithunzichi pamwambapa, Pulogalamu A ikuwonetsa zomwe QRS zovuta zimawonekera pa ECG yachibadwa.
(Kwa iwo omwe ali ndi chidwi, chiwerengerochi chikuwonetsa kutsogolera ine kuchokera ku ECG yotsogolera 12). Popeza kuti zamoyo zonsezi zimalandira mphamvu yokoka pamagetsi panthawi imodzimodzi, zovuta zowonjezereka za QRS ndizochepa (nthawi zambiri zosakwana 0.1 peresenti.) Kulimbikitsana panthawi imodzi kumagwirizanowu kumadalira mphamvu ya magetsi kuyenderera pansi nthambi zonse zabwino ndi zamanzere pafupi ndi mlingo womwewo wa liwiro.
Cholinga cha Nthambi ya Nthambi: Tanthauzo
Ntchito ya nthambi za mtolo ndi kugawira kufalikira kwa magetsi pamagetsi amodzimodzi, kotero kuti pamene mgwirizano wamagetsi (kuchotsa magazi kunja kwa mtima), amachititsa zimenezi mwachangu komanso moyenera. Nthambi yoyenera yachitsulo imapereka mphamvu yogwiritsira ntchito magetsi kuntchito yolumikiza bwino, ndipo nthambi ya kumanzere yomwe imachokera kumalo otere imapereka mpata wopita kumbuyo kwa ventricle.
Muchitetezo cha nthambi, imodzi kapena nthambi ziwiri zonsezi sizikutulutsanso zofuna za magetsi. Izi zimachitika chifukwa cha matenda kapena kuwonongeka kwa nthambi imodzi yamitolo, monga momwe zingachitikire ndi matenda a mtima wamtundu wa myocardial kapena matenda a mtima .
Komabe, nthambi yamatabwa ikhoza kuchitika chifukwa chabe chifukwa chomveka chokhala ndi thanzi labwinobwino.
Pamene mphamvu ya magetsi ikuchedwa kufika pamakina ake ozungulira, kuchedwa kukuwonetsa ngati njira yosiyana pa ECG yotchedwa bundle branch block. Zomwe zimakhudza bwalo la nthambi ndilokuti zimasokoneza kupangika kanthawi imodzi komweko. Kusemphana kwa chiwombankhanga chimodzi (chomwe chili ndi nthambi yotsekedwa "yotsekedwa") chimapezeka kokha kutsogolo kwa wina, osati nthawi yomweyo.
Onani kuti pamene mawu akuti bundle "block" akugwiritsidwa ntchito, nthambi yothandizidwa ikhoza kapena "siikutsekedwa." Nthaŵi zambiri, nthambi yokhoma sizimaletsedweratu, koma imangotulutsa mphamvu ya magetsi pang'onopang'ono kuposa chosiyana ndi mtolo nthambi.
Kodi Munda wa Nthambi Umayang'ana Bwanji pa ECG?
Anthu omwe ali ndi nthambi yamatabwa kawirikawiri amakhala ndi bwalo lamatabwa labwino (RBBB) kapena bwalo lachitsulo la nthambi (LBBB), malingana ndi zomwe nthambi ziwirizo zimakhudzidwa. Magulu A B ndi C omwe ali muwonekedwewa amasonyeza kusintha kwa khalidwe komwe kumachitika pa QRS zovuta pamene munthu achoka kapena bwalo lachitsulo. Pazochitika zonsezi, makompyuta a QRS amakhala aakulu kuposa momwe amachitira, chifukwa zimatengera nthawi kuti magetsi agwiritsidwe ntchito ponseponse pozungulira. Mmene mawonekedwe a QRS amavumbula amavumbulutsira nthambi yomwe ili kumanja kapena kumanzere.
Nthawi zina, nthambi zonse zimakhudzidwa, ndipo nthambi yamagulu yomwe imagwira ntchito ku ECG sichidziwikiratu kuti ndi yoyenera kapena yotsalira. Pankhaniyi, bwalo la nthambi likutchulidwa kuti "kuchepetsa kupititsa patsogolo."
Zizindikiro ndi Mavuto
Nthaŵi zambiri, mtolo wa nthambi sizimabweretsa zizindikiro. Komabe, m'nthambi yayikulu yamagetsi amachititsa kuti magetsi azitha kufika pamakina am'mlengalenga akhoza kukhala ovuta kwambiri. Pazochitikazi, chidziwitso chikhoza kutsekedwa mwadzidzidzi kuti asadzafike pazitsulo zam'mimba, zomwe zimawatsogolera pamtima - zomwe zingabweretse syncope kapena imfa ya mtima mwadzidzidzi .
Nthawi zina kukhalapo kwa mtolo wa nthambi kumasonyeza kukhalapo kwa vuto lalikulu la mtima. Choncho, pamene nthambi yamatabwa imadziwika, madokotala ambiri amalimbikitsa kuunika kwa mtima kosagwiritsidwa ntchito (nthawi zambiri, kachipangizo kake ).
Momwe Makhalidwe A Nthambi Amachitira
Nthawi zambiri, bwalo la nthambi lokha silimasowa chithandizo. Komabe, nthawi zina anthu omwe ali ndi bwalo lachitsulo lamanzere ayenera kulandira pacemaker , makamaka, yomwe imatsitsimutsanso kugwirizanitsa makina awo .
Mawu Ochokera
Bungwe la nthambi ya nthambi ndilofala kwambiri pa ECG. Ngakhale kuti anthu omwe ali ndi mabokosi a nthambi ayenera kulandira kafukufuku wa mtima kuti ayang'ane matenda a mtima, nthawi zambiri nthambi yowonjezera yokha siimabweretsa vuto lalikulu.
> Chitsime:
> Surawicz B, Childers R, Wokondedwa BJ, et al. AHA / ACCF / HRS Zolinga za Kukhazikitsidwa ndi Kutanthauzira kwa Electrocardiogram: Gawo III: Kusokonezeka Kwambiri M'kutsogolera: Scientific Statement kuchokera ku American Heart Association Electrocardiography ndi Arrhythmias Committee, Council on Clinical Cardiology; American College of Cardiology Foundation; ndi Heart Rhythm Society. Ovomerezedwa ndi International Society for Computerized Electrocardiology. J Am Coll Cardiol 2009; 53: 976.