I-electrocardiograph yokuqala yehlabathi yenziwa ngasekupheleni kweXesha le-19 ngeNgqapheli wezonyango kwiNgesi. Ukuqulunqa kwakhe kwakuyiphumelelo ngokwenene ekuxilongweni kwezifo zentliziyo . Ukususela ekuqaleni kwekhulu lama-20, esi sixhobo esiyimfuneko siye saqhubeka siphucukisiwe emsebenzini we-cardiologist, kwaye nanamhlanje akukho sibhedlela singakwazi ukulawula ngaphandle kwayo.
Uhlolo lweHolter lubonisa ntoni?
Xa kuxilongwa izifo zentliziyo, i-ECG ibaluleke kakhulu. Impendulo yodwa yale ndlela, eyayiyinkimbinkimbi yokuxilongwa kwezilwanyana, kwakungenakukwazi ukugcina umsebenzi wentliziyo ixesha elide. Wakwazi ukuphelisa i-American Norman Holter ngo-1961, waqulunqa i-cardiograph ephathekayo, eyayibizwa ngokuba ngumntu ososayensi onetalente.
"I-Holter" yanamhlanje isixhobo esincinci, esivumela ukuba siphathe emzimbeni ngaphandle kokuphazamiseka okubonakalayo. Ukubeka iliso kwimihla ngemihla ye-ECG ngo-Holter kukulawulwa okuqhubekayo kwintliziyo yesigulane kwisigxina sakhe. Ngoncedo lwakhe, ugqirha uyayilungisa iimpawu ze-pathology kwaye ibeka isizathu sayo. Olu hlobo lokuxilongwa lwenziwa ngeendlela ezahlukeneyo:
- Ingxelo epheleleyo yentliziyo yesigulane seentsuku eziliqela, ebhalisa malunga neenkulungwane zeentliziyo.
- Ngoxa uncediswa ukufakelwa kwe-hypodermic, ukubhaliswa kwe-large scale kwenziwa ngeenyanga ezininzi.
- Uvavanyo lweengqungquthela zomsebenzi wentliziyo ngexesha lokuzikhandla emzimbeni okanye intlungu esiswini. Kule meko, ifowuni isebenza ngokucinezela iqhosha ngumguli ngokwakhe.
Ukujonga iliso - ukutolika
Ukuqwalasela i-ECG ye-decoding holterovskogo yenze inkqubo ekhethekileyo yekhompyutheni, efakwe kwi-decoders yeklinikhi. Isigaba sokuqala se-electro-classification senziwa yile divayili ngokwayo kwinkqubo yokusebenza. Yonke idatha ebhalwe yidivayisi, i-cardiologist ingena kwikhompyutha, ilungisa kwaye ibhale isiphelo. Emva kokuhlaziya kunye nokuhlalutya ngokucophelela kweziphumo zokubeka esweni, isiguli siyafumana isigqibo esiphezulu kunye nokuthunyelwa kwonyango, ukuba kuyimfuneko.
Inkcazo yeziphumo zokubeka esweni ziqhutywa ngokwemiqathango elandelayo:
- bonisa uhlobo kunye nohlobo lokubonwa;
- ukuphindaphindwa kweentlobo zentlupheko yesifo senhliziyo phezu kwexesha lonke lokuqwalasela;
- ichaza uhlobo lweentliziyo: eziqhelekileyo, ezinqabileyo okanye ezikhawulezayo;
- izinga lentliziyo ngexesha lokuzilolonga kunye nokuphumla;
- kukho i- arrhythmia , ukuba ikhona, kunye nezinye izitenxo entliziyweni;
- inani lamatyala e-tachycardia kunye nokuxhamla kwabo okunokwenzeka ngokuxinzelela ngokomzimba okanye kwengqondo kubhalwe;
- utshintsho kwisayithi yokugqibela yesakhiwo esinamandla;
- utshintsho lwexesha eliphakathi kwePQ ne-QT.
Ukubeka iliso kwi-Holter kuyinto evamile
Iingcali eziqeqeshekileyo ziyakwazi ukuvavanya ngokufanelekileyo umsebenzi oqhelekileyo okanye ukufumanisa i-pathology ye-myocardium. Ukuxilongwa kubeka isigxina se-heart muscle, ukulungelelaniswa kwegazi okanye ukufumaneka kwe-oksijini yindlala. Isiqhelo sisigqi sesinus ye-myocardium kunye nenqanaba lentliziyo ngaphakathi kwe-85 beats ngomzuzu. Ukubeka esweni isigxina somzimba sisetyenziselwa ukutshutshiswa kwesifo senhliziyo.
Izibonakaliso zesi sifo zivela ngokunciphisa ukuqhutyelwa kwamathambo e-coronary. Kule meko, uHolter ubhalisa ukudandatheka kwi-ST. Inkcazo ye-ischemia yokubeka iliso kwiHolter yancipha kwi-ST ukuya kwi-0.1 mV. Uvavanyo lwenhliziyo ephilileyo luya kubonisa omnye umfanekiso: umgangatho wokuba kungekho HD ukhangelwa ukuba ukunyuka kwale ndawo kuya kwi-1 mm.
Inkqubo yokubeka esweni
Uninzi lwezifo zengqondo kwiqalo lokuqala alibanga iimpawu ezithile. Isigulana sinokuziva singathandeki esifubeni kuphela ngexesha lokusebenza okanye ebusuku. Ukungaphumeleli kwesiginci senhliziyo (i-arrhythmia), ebonakalayo ngokunganyaniseki, kunzima kakhulu ukuchonga kwinkqubo yokuqhuba i-electrocardiogram eqhelekileyo kwiklinikhi.
Kwiimeko ezinjalo, uHolter ECG inkqubo yokubeka iliso iza kunceda izazi ze-cardiologists, ezichaza umsebenzi we-myocardium emini. Amashishini anamhlanje ahluke kwiisampula zokuqala ngobukhulu kunye nobukhulu, okuvumela isigulane ukuba siphile ngendlela yokuphila. Yonke idatha yokuqala ichanekile ngokuthe tye kunye nokuthembeka, oko kukukhawuleza ngokukhawuleza ukucaciswa kwesizathu sentsholongwane yomzimba.
I-Electrode ihamba kwi-Monitoring Holter
I-electrocardiogram ehambayo eyenziwa ngubabhalisi, obhala ukufundwa kwentlawulo yenhliziyo usebenzisa i-electrodes elahlayo. Idivaysi ngokwayo i-holterovskogo iliso isebenza kwiibhetri kwaye ikhona kwisibilini sesigulane kwimeko ethile. I-Apparatus yokubeka iliso ngokuqhubekayo kwemizimba yenhliziyo, ngokuxhomekeke kumzekelo, ithatha kwi-2G ezizimeleyo ze-ECG kwaye ixhotywe ngentambo ene-5, 7 okanye 10 amasebe apho kufakwe khona i-electrodes. Zijonge kwisifuba sesigulane usebenzisa i-patch kwindawo kunye nenani elincinci leethambo.
Ngexesha lophando, i-gel ekhethekileyo ifuna ukunyusa ukwenziwa kombane komzimba. Iindawo zesikhumba kunye neengcingo zecandelo le-electrode zandulela unyango kunye nesisombululo sokucoca kunye nokuhla. Zonke ezi zinto zenziwa ngamagosa afanelekileyo kwi-polyclinic.
Ukubeka iliso kwi-ECG kunye noxinzelelo lwegazi
Kwimizekelo yamatyala, isiguli sidinga ukufundwa kabini. Ukongezelela ukubeka esweni umsebenzi we-myocardium, ugqirha unokukwazi ukulandelelanisa ukuguqulwa kwengcinezelo yomgulo wesigulane. Ukubeka iliso kwansuku zonke kwi-ECG Holter kunye ne-BP imiselwe ukuba ziqinisekise okanye zikhanyele ukuxilongwa kwangaphambili, umzekelo, kwi-IHD.
Ukubeka iliso kwi-ECG
Ukubeka iliso kwi-ECG kwiHolter yirekhodi engummiselo wezokwehlukana kwe-myocardial, enye yezona ndlela ezimbini ezibalulekileyo zokuxilonga ngezifo ezahlukahlukeneyo zesimo senhliziyo. Kuqwalaselwa ngokugqithiseleyo ekufumaneni i-arrhythmia kunye nefom ye-myocardial ischemia. Ngokuqhelekileyo, ezi zifo zihamba kunye nomfutho wegazi ophezulu okanye u-hypotension.
Ukujongana noxinzelelo lweHolter
Le ndlela ibandakanya ukubeka isikhephe kwisigulane sogulane esenza isixhobo kunye nokunyanzeliswa kwengcinezelo yegazi ngokufanayo ne-electrocardiogram. Ngamanye amaxesha ukuhluleka kwentlawulo yenhliziyo ngokuxhomekeke kwi "jumps" yexinzelelo lwegazi ngamaxesha athile emini okanye ngenxa yokukhathazeka ngokomzimba okanye ngokomzwelo. Ukubekwa kweliso lwexinzelelo lwegazi kwi-holter kunceda ukuseka olu lwalamano, ukufumana nokuphelisa imbangela yokugula.
Ukujonga iliso - indlela yokuziphatha?
Izigulane eziye zanikwa i-Monitor Holter nganye kufuneka zilungele kakuhle. Akukho nkathazo ethile kwilo qeqesho. Kukho imiba emibini ebalulekileyo yokuqwalasela:
- Ngaphambi kokuba uqale inkqubo, kubalulekile ukuba uhlambe okanye uhlambe kwisitya, njengoko iyunithi akufanele ifakwe kwi-water.
- Kwiingubo kunye nomzimba akufanele kubekho imveliso yensimbi.
- Kubalulekile ukulumkisa ugqirha malunga namayeza athatyathwe ukuba akakwazi ukukhanselwa.
- Kubalulekile ukunika iziphumo zeengcali zokuhlalutya nezinye iindlela zokuxilonga.
- Kubalulekile ukuxelela abasebenzi bezonyango malunga nobukho be-pacemaker, ukuba kukho.
- Ungagxininisi kwisixhobo oza kulala ngexesha losuku, njengoko oku kunokuchaphazela iziphumo zophando. Umoya ogqithiseleyo awunakusetyenziswa. Zama ukusebenzisa ixesha eliqhelekileyo kwishishini eliqhelekileyo.
Ukubeka iliso kwi-Holter - into engenakuyenza?
I-Daily Holter yokubeka iliso kwi-ECG yindlela efanelekileyo yokuxilonga efuna isigulane ukuba ihambelane nemithetho ethile:
- Ungasebenzisi izixhobo zombane (i-toothbrush, i-razor, i-dryer dryer, njl.).
- Hlala kumgama owaneleyo kwi-oven microwaves, i-detectors zensimbi kunye namagnet.
- I-X-ray, i-ultrasound, i-CT okanye i-MRI ayinakuyenza ngexesha lokubeka iliso.
- Ebusuku, ulale kumqolo wakho ukuze idivayisi ayixhomekeke kuxinzelelo lwangoku.
- Ungagqoki ngaphantsi kweengubo zangaphandle okanye iimpahla zangaphandle.
I-Holter Monitoring Diary
Uhlolo lwezinga lentliziyo yeHolter alukhawulelwanga ekugqokeni isixhobo. Ngexesha le nkqubo, isiguli sigcina idayari apho athi:
- ixesha lomsebenzi kunye nomsebenzi;
- ixesha kunye nohlobo lokuphumla;
- uluhlu lweemveliso zokutya kunye neziyobisi;
- sebenza ekhaya;
- yomsebenzi;
- isimo sengqondo;
- ixesha kunye nomgangatho wokulala;
- ukuthatha amayeza kunye nenkcazo yexesha elichanekileyo; Lo mbandela ubaluleke kakhulu ukuba uhlolo lweHolter lwexinzelelo lwegazi lwenziwa ngokufanayo;
- ubukho beentlungu ezingathandekiyo okanye ezibuhlungu kwintsimi yentliziyo, isiyezi, isimo esandulelayo, intloko, njl njl.
Emva kokuphela koviwo, isixhobo sisuswa kwisigulane. Idatha yombhalisi kunye neirekodi ezivela kwidayari zifakwa kwikhompyutheni yokucubungula, kwaye ngoko-cardiologist yenza izilungiso kwaye ibhala isigqibo.