Iko electrocardiograph yekutanga yenyika yakasikwa kuma1900 ekupera kwezana remusayendisiti wezvokurapa wokuEngland Waller. Mukurumbira wake wakagadzikana chaizvo mukuongororwa kwezvirwere zvepfungwa . Kubva kutanga kwezana remakore rechi20, chinhu ichi chinodiwa chave chichienderera mberi chichivandudzwa mubasa revanhu vane mapiritsi, uye nhasi hapana chipatara chinogona kutarisira pasina.
Chii chinonzi Holter monitoring chinoratidza?
Mukuongororwa kwezvirwere zvepfungwa, ECG inokosha zvikuru. Nharo yega yega nzira iyi, iyo yakaomesesa kuongororwa kwehutachiona, ndiko kusakwanisa kuchengeta basa remwoyo kwenguva refu. Akakwanisa kubvisa American Norman Holter muna 1961, akagadzira cardiograph inotakura, yakatumidzwa zita reasayendisiti ane tarenda.
Iko "Holter" yemazuva ano inogadzirisa zvishoma, iyo inobvumira kuitakura mumuviri pasina chero kuonekwa kwakashata. Zuva rega rekuongorora kweEECG neHolter inoramba ichidzora mutsara wemwoyo wemurwere mune zvaanenge achigadzirira. Nekubatsira kwake, chiremba anogadzira zviratidzo zvehutano uye anosimbisa chikonzero chacho. Urwu urwere hwekuongororwa hunoitwa nenzira dzakasiyana:
- Tsanangudzo yakajeka yemwoyo murefu wemurwere kwemazuva anoverengeka, iyo inonyora nezvemazana zana emwoyo.
- Nekubatsira kwekusimudzira hypodermic, kunyorwa kwemahombekombe kwakaitwa kwemwedzi yakawanda.
- Chiitiko chepfungwa chebasa romwoyo panguva yekushanda mumuviri kana kurwadziwa mubhokisi. Muchiitiko ichi, chigadzirwa chacho chinoshandiswa nekufambisa bhatani nemurwere pachake.
Kurinda kuongorora - kududzira
Decoding holterovskogo kuongorora ECG yakagadzira purogiramu yakakonzerwa yemakombiyuta, yakagadzirirwa mumakiriniki emagetsi. Chikamu chekutanga che electro-classification chinoshandiswa nejecha pachake mukushanda kwekushanda. Zvose dhesi rakanyorwa nechokushandisa, chiremba chepodhi inopinda mumakombiyuta, inogadzirisa uye inonyora kuguma. Mushure mokufungisisa uye kunyatsoongorora kwekuona kwekuongorora, murwere anogamuchira mhedziso yakajeka uye kutumira kurapwa, kana zvichidikanwa.
Tsanangudzo yekutarisa zvinogadziriswa inoitwa maererano nemitemo inotevera:
- kuratidza rudzi uye rudzi rwekucherechedza;
- huwandu hwezvipembenene zvepfungwa yemwoyo pamusoro pekuona nguva yose;
- rinotsanangura rudzi rwekushaya moyo: rwemazuva ose, rusingaoneki kana kukurumidza;
- kuraya kwemwoyo panguva yekurovedza uye pazororo;
- pane chirongwa chemukati , kana chiripo, nezvimwe zvisina kukodzera mumoyo;
- nhamba yezviitiko zve tachycardia uye kukwanisa kwavo kushamwaridzana nemagariro epanyama kana kwepfungwa zvakanyorwa;
- kuchinjwa munzvimbo yekupedzisira yezvinetso zve ventricular;
- kuchinja kwezvikamu PQ neQT.
Hovha yekuongorora ndiyo inowanzo
Mumwe nyanzvi anoziva anogona kunyatsoongorora basa rakanaka kana kuona chirwere chemyocardium. Kuongororwa kunogadzirisa mamiriro emwoyo mususu, kukwana kweropa rayo kana kuvepo kwomweya wekushaya nzara. Chimiro ndicho chimiro chechirimusi chemyocardium uye moyo wepakati mukati ma-85 kurova paminiti. Zuva roga roga rwiyo rwekuongorora rinoshandiswa pakufungidzirwa kuti ischemic heart disease.
Zviratidzo zvechirwere ichi zvinoratidzika nekunonoka kwekutengesa kweerononicteri. Muchiitiko ichi, Holter anonyora kuora mwoyo mune ST segment. Iko ischemia index yeHolter kuongorora inoderera mu ST kusvika 0.1 mV. Kuongororwa kwemwoyo wakagadzikana kucharatidza mumwe mufananidzo: chimiro mukusavapo kweHD kunofungidzirwa kuti ndiko kukwira kwedenga iri kusvika 1 mm.
Holter monitoring system
Zvirwere zvakawanda zvepfungwa mumutambo wekutanga hazvikonzeri zviratidzo zvakananga. Murwere anogona kunzwa asinganzwisisiki mubhokisi chete panguva yehupenyu hunoita kana usiku. Kukundikana kwechimiro chemwoyo (arrhythmia), iyo inoratidzirwa nokusakanganiswa, kwakaoma zvikuru kuziva mukugadzirisa kwema electrocardiogram yakawanda mumakiriniki.
Mumamiriro ezvinhu akadaro, Holter ECG yekuongorora nzira inouya kune rubatsiro rwevadzidzi ve cardiologists, inotsanangura basa remyocardium masikati. Mishonga yemazuva ano yakasiyana nedzimwe sampuli dzokutanga mudiki mashoma uye uremu, izvo zvinoita kuti murwere atungamirire mararamiro ehupenyu. Zvose dhekutanga dheyo ine zvakanyatsoruramisa uye kuvimbika, izvo zvinowedzera kukurumidza kujekeswa kwechikonzero chemoyo wepachiviri.
Electrode inopinda muHolter kuongorora
Iko electrocardiogram inoshandiswa inoshandiswa nevanyori, iyo inoratidzira kuverenga kwemoyo ye mwoyo kushandiswa kwemagetsi emagetsi. Iko pachake pachayo holterovskogo yekushanda inoshanda pa mabhatiri uye iri pachiuno chechiremba mune imwe nyaya yakakosha. Zvishandiso zvekuenderera mberi kwekutarisa kwemasikirini emwoyo, zvichienderana nemuenzaniso, inotora kubva kumakero maviri eEGG akazvimiririra uye yakagadzirirwa tambo ine matavi mashanu, 7 kana 10 ayo ma electrode akabatanidzwa. Iyo yakagadzirirwa pachipfuva chemurwere achishandisa chikwata munzvimbo dzakasiyana-siyana zveadipose tissue.
Munguva yekuongorora, gel rinokosha rinofanirwa kubatsira kubvisa magetsi ekufambisa muviri. Nzvimbo dzeganda nesimbi zvikamu zve electrode zvinotangira kurapwa nechinatswa chekuchenesa uye kupera. Zvose izvi zvinoshandiswa nevanyanzvi vanogona mu polyclinic.
Kuchengeta kutsvaga kweEECG uye ropa
Mune zvimwe zviitiko, murwere anoda kudzidza kaviri. Mukuwedzera pakucherechedza basa remuyocardium, chiremba ane mano ekucherechedza kushandiswa kwesimba rinokonzerwa nemurwere. Zuva nezuva kuongorora kweEECG Holter neBP inorayirwa kuti isimbise kana kuti irege kutanga kuongororwa, somuenzaniso, muHD.
Chengetedza kuongorora kweEECG
Kuongorora kweEGG muHolter ibhuku rinogara richiratidza maitiro emheyoti, iyo ndiyo imwe yenzira mbiri dzekuongorora zvirwere zvakasiyana-siyana zvehutano hwemwoyo. Inofungidzirwa kuti inoshanda zvikuru pakuona urongwa hwemagirthmia uye inonzi latent form of myocardial ischemia. Kazhinji, zvirwere izvi zvinosangana nehuwandu hwehutano kana hutsika.
Holter Pressure Monitoring
Iyi nzira inosanganisira kuisa mukombe pamapfudzi ejeri unobatanidza chigadziro uye kuwedzera kushanda kweropa nenzira yakafanana ne electrocardiogram. Dzimwe nguva kukanganisa kwepfungwa yemwoyo zvakananga kunobva pane "kuputika" kweropa rinosvika pane dzimwe nguva dzemazuva kana semagumisiro emuviri kana mupfungwa. Kuongororwa kweropa kumhepo kune holter kunobatsira kusimbisa ukama uhwu, kuwana uye kubvisa chinokonzera chirwere.
Kuchengeta kutsvaga - maitiro ekuzvibata sei?
Varwere vakagoverwa zuva roga roga Holter kuongorora vanofanira kunyatsogadzirira. Hakuchina kuoma kwakanyanya mukurovedza kwakadaro. Pane zvinhu zvinokosha zvakakosha kufunga nezvazvo:
- Usati watanga nzira yacho, zvakakosha kutora kugeza kana kushambidza mumvura, sezvo chikwata chisingafaniri kubudiswa mumvura.
- Pamapfeko uye pamuviri hapanofanira kuva nemishonga yesimbi.
- Zvakakosha kunyevera chiremba nezvemishonga inotorwa kana isingagoni kukwaniswa.
- Zvakakosha kupa mhizha yehutano hwekuongorora uye dzimwe nzira dzekuongorora.
- Zvakakosha kuzivisa vanachiremba nezvekuvapo kwe pacemaker, kana pane.
- Usaisa pfungwa pane chigadziro chauchave uchipfeka masikati, sezvo izvi zvingakanganisa migumisiro yeongororo. Kuwedzerwa manzwiro hakuzoshandisi. Edza kushandisa nguva ino seyakajairika pamabhizimisi akawanda.
Kuchengeta kutsvaga - chii chisingagoni kuitwa?
Daily Holter ECG kutarisa inzira inobatsira uye inofanirwa kuongororwa inoda murwere kuomerera kune mamwe mitemo:
- Usashandise magetsi mashizha (mazino, jira, mvere dzakaoma, nezvimwewo).
- Gara pane imwe nzvimbo yakakwana kubva muuchivhenekera, michina yesimbi uye magetsi.
- X-ray, ultrasound, CT kana MRI haigoni kuitwa panguva yekuongorora.
- Usiku, rara pamusana wako kuitira kuti chigadzirwa chacho chisati chichigadziriswa.
- Usapfeke zvigadzirwa zvepurasitiki kana zvekunze.
Holter Monitoring Diary
Holter's heart rate monitoring haisi kurega kupfeka chigadzirwa. Panguva yekufamba, murwere anochengeta diary iyo anoti:
- nguva yezuva rokubata uye basa;
- nguva uye rudzi rwekuzorora;
- urongwa hwezvokudya zvekudya uye zvinwiwa;
- kushanda kumba;
- kuita basa;
- manzwiro emuviri;
- nguva uye unhu hwekurara;
- kutora mishonga nezviratidzo nguva chaiyo; ichi chinhu chakakosha kana Holter kuongorora kwekushandiswa kweropa kunoitwa nenzira yakafanana;
- kuvapo kwekunzwa kusingafadzi kana kunorwadza munharaunda yemwoyo, chizuru, chimiro chekutanga, chimiro chepfungwa, nezvimwewo.
Mushure mokuguma kwekuongorora, chigadzirwa chacho chinobviswa kubva murwere. Dhiyabhorosi uye zvinyorwa kubva mudhidhiyari zvinowanikwa mumakombiyuta kuti zvigadziridzwe, uye zvino chirwere chemaroto chinogadzirisa uye chinonyora kuguma.