I-electrocardiograph yokuqala yezwe yasungulwa ngasekupheleni kwekhulu le-19 ngumsayense wezokwelapha waseNgilandi Waller. Ukwakhiwa kwakhe kwaba ukuphumelela kwangempela ekuxilongweni kwezifo zenhliziyo . Kusukela ekuqaleni kwekhulu lama-20, leli thuluzi elidingekile liye lathuthukiswa ngokuqhubekayo emsebenzini wezinhliziyo zegazi, futhi nanamuhla akukho esibhedlela esingaphatha ngaphandle kwalo.
Ukuqapha kweHolter kubonisa ngani?
Lapho kutholakala izifo zenhliziyo, i-ECG ibaluleke kakhulu. Ukuhlukunyezwa okuphela kwalendlela, okuyinto eyinkimbinkimbi yokuxilongwa kwe-pathologies, kwakuwukuhluleka ukugcina umsebenzi wenhliziyo isikhathi eside. Wakwazi ukuqeda i-American Norman Holter ngo-1961, wakha i-cardiograph ephathekayo, eyayibizwa ngokuthi isosayensi onolwazi.
"I-Holter" yesimanje iyisisetshenziswa esincane, esivumela ukuba siyithwale emzimbeni ngaphandle kokuphazamiseka okubonakalayo. Ukuqapha kwansuku zonke kwe-ECG nguHolter ukulawula okuqhubekayo kwenhliziyo yesiguli esimweni esivamile. Ngosizo lwakhe, udokotela ulungisa izimpawu ze-pathology futhi usungula imbangela yayo. Lolu hlobo lokuxilongwa lwenziwa ngezindlela ezahlukene:
- Irekhodi eningiliziwe yesiguli senhliziyo yesiguli izinsuku ezimbalwa, esibhalisa izinhliziyo eziyizinkulungwane eziyikhulu.
- Ngosizo lwe-implantation ye-hypodermic, ukubhaliswa okukhulu kubonakala izinyanga eziningi.
- Ukuhlola okuqakathekileko komsebenzi wenhliziyo ngesikhathi kusebenza ngokomzimba emzimbeni noma ubuhlungu esifubeni. Kulokhu, idivayisi isebenza ngokucindezela inkinobho isiguli ngokwayo.
Ukuqapha kwe-Holter - incazelo
Ukunquma i-holterovskogo yokuqapha i-ECG yenza uhlelo olukhethekile lwekhompyutha, olufakwe kuma-decoders omtholampilo. Isigaba sokuqala se-electro-classification senziwa yidivayisi ngokwalo ohlelweni lokusebenza. Yonke idatha erekhodiwe yidivayisi, i-cardiologist ingena kukhompyutha, ilungisa futhi ibhale isiphetho. Ngemuva kokuhlaziya nokuhlaziywa ngokucophelela kwemiphumela yokuqapha, isiguli sithola isiphetho esinemininingwane nokudlulisela ukwelashwa, uma kunesidingo.
Incazelo yokuqapha imiphumela yenziwa ngokwemigomo elandelayo:
- khombisa uhlobo nohlobo lokubheka;
- imvamisa yezingqinamba zezinsizwa zenhliziyo phezu kwesikhathi sonke sokubheka;
- ichaza uhlobo lokushaya kwenhliziyo: okujwayelekile, okungajwayelekile noma okusheshayo;
- isilinganiso senhliziyo ngesikhathi sokuvivinya umzimba nokuphumula;
- kukhona i- arrhythmia , uma ikhona, nezinye iziphambeko enhliziyweni;
- inani lamacala e-tachycardia kanye nokuxhumeka kwabo okungenzeka ukucindezeleka ngokomzimba noma kwengqondo kubhaliwe;
- izinguquko esakhiweni sokugcina senkimbinkimbi yezakhi;
- ukushintsha kwezikhathi ze-PQ no-QT.
Ukuqapha kwe-Holter kuyinto evamile
Uchwepheshe oqeqeshiwe angahlola ngokufanele umsebenzi ojwayelekile noma ahlole i-pathology ye-myocardium. Ukuxilongwa kuthatha isimo senhliziyo, ukutholakala kwegazi noma ukutholakala kwendlala yomoya. Isimiso yisigqi sesinus se-myocardium nesilinganiso senhliziyo ngaphakathi kwezingu-85 ngomzuzu. Ukuqapha kwengqondo yansuku zonke kusetshenziselwa ukusolakala ukuthi isifo senhliziyo ischemic.
Izimpawu zalesi sifo zivela ngokunciphisa ekuqhutheni kwe-coronary arteries. Kulokhu, uHolter ubhalisa ukucindezeleka esigabeni se-ST. Inkomba ye-ischemia yokuqapha kwe-Holter iyancipha ku-ST kuya ku-0.1 mV. Ukuhlolwa kwenhliziyo enempilo kuzokhombisa esinye isithombe: ukujwayelekile lapho kungekho khona i-IHD kubhekwa ukuthi ukuphakama kwalendawo kuya ku-1 mm.
Uhlelo lokuqapha indawo
Izifo eziningi zenhliziyo esiteshini sokuqala azibangeli izimpawu ezithile. Isiguli singazizwa singakhululekile esifubeni kuphela phakathi nokuphila okusebenzayo noma ebusuku. Ukwehluleka kwesiginci senhliziyo (arrhythmia), esibhekene nokungahambisani, kunzima kakhulu ukubona ukuthi kusebenza kanjani i-electrocardiogram ejwayelekile emtholampilo.
Ezimweni ezinjalo, uhlelo lokuqapha i-Holter ECG luya ekusizeni izazi ze-cardiologists, ezichaza umsebenzi we-myocardium emini. Imishini yanamuhla ihluke kumasampula okuqala ngesayizi encane nesisindo, okuvumela isiguli ukuba senze indlela yokuphila evamile. Yonke idatha yokuqala iqondile futhi inokwethenjelwa, okusheshisa kakhulu ukucaciswa kwesizathu se-pathologies yenhliziyo.
I-electrode ihlangana ngokuqapha kwe-Holter
I-electrocardiogram ephathekayo yenziwa ngumbhalisi, orekhoda ukufundwa kwezinga lenhliziyo usebenzisa ama-electrode alahlekile. Idivayisi ngokwayo yokuqapha holterovskogo isebenza amabhethri futhi itholakala okhalweni lwesiguli ngendlela ekhethekile. I-apparatus yokuqapha okuqhubekayo kwemizimba yenhliziyo, kuye ngokuthi imodeli, ithatha iziteshi ezizimele ezi-2 kuya ku-12 ezizimele futhi ifakwe ikhebula ngamagatsha angu-5, 7 noma angu-10 okuhlanganiswa kuwo ama-electrode. Zigxile esifubeni sesiguli besebenzisa i-patch ezindaweni ezinenani elincani lezinyosi ze-adipose.
Ngesikhathi sokuhlola, i-gel ekhethekile kufanele ikhulise ukuqhutshwa komzimba kagesi. Izindawo zesikhumba kanye nezingxenye zensimbi zamakhemikhali ziphethwe ngaphambili ngekhambi lokuhlanza futhi liyeke. Zonke lezi zinqubo zenziwa ngabachwepheshe abaqeqeshiwe kule polyclinic.
Ukuqapha kwe-ECG nokucindezelwa kwegazi
Ezimweni eziningi, isiguli sidinga ukutadisha kabili. Ngaphandle kokuqapha umsebenzi we-myocardium, udokotela unamandla okulandelela ukuguqulwa kwengcindezi yomzimba yesiguli. Ukuqapha kwansukuzonke ku-ECG Holter ne-BP kunqunyelwe ukuqinisekisa noma ukuphika ukuhlolwa kokuqala, isibonelo, ku-IHD.
Ukuqapha kwe-ECG
Ukuqapha kwe-ECG eHolter kuyinhlangano yokugcina imidwebo ye-myocardial contractions, okuyisinye sezici ezimbili eziyinhloko zokuxilonga ngezifo ezihlukahlukene zesimiso senhliziyo. Kubhekwa njengendlela ephumelela kakhulu ekutholeni ukuhleleka kwesimo se-myocardial ischemia. Ngokuvamile, lezi zifo zihambisana ne-hypertension noma hypotension.
Ukuqapha kwe-Holter Pressure
Le ndlela ihilela ukubeka isikhumba esikhwameni segulane esijoyina idivayisi futhi silinganise ukucindezelwa kwegazi ngokuhambisana ne-electrocardiogram. Ngezinye izikhathi ukuhluleka kwenani lenhliziyo ngokuqondile kuxhomeke ekujuleni kwe-blood pressure ngezikhathi ezithile zosuku noma ngenxa yokucindezeleka ngokomzimba noma ngokomzwelo. Ukuqapha ukucindezelwa kwegazi ku-holter kusiza ekusunguleni lobu buhlobo, ukuthola nokuqeda imbangela yokugula.
Ukuqapha kwe-Holter - indlela yokuziphatha?
Iziguli ezinikezwe ukuqapha kwe-Holter nsuku zonke kufanele zilungele kahle. Ayikho inkimbinkimbi ethile ekuqeqesheni okunjalo. Kunezici ezimbalwa ezibalulekile okufanele uzicabangele:
- Ngaphambi kokuqala inqubo, kubalulekile ukugeza noma ukugeza eshaweni, njengoba i-unit akufanele ivulelwe emanzini.
- Ngezingubo nasemzimbeni akufanele kube nemikhiqizo yensimbi.
- Kubalulekile ukuxwayisa udokotela mayelana nemithi ethathwe uma bengakwazi ukukhanselwa.
- Kubalulekile ukunikeza imiphumela yobuchwepheshe bokuhlaziya nezinye izindlela zokuxilonga.
- Kubalulekile ukwazisa abasebenzi bezokwelapha mayelana nokuba khona kwe-pacemaker, uma kukhona.
- Ungagxila kudivayisi oyothola phakathi nosuku, njengoba lokhu kungathinta imiphumela yocwaningo. Umzwelo owedlulele ngeke usebenzise. Zama ukuchitha lesi sikhathi njengesijwayelekile kubhizinisi elivamile.
Ukuqapha kwe-Holter - yini engeke yenziwe?
Ukuqapha kwe-ECG ye-Daily Holter kuyindlela ewusizo futhi edingekayo yokuxilonga okudinga isiguli ukuba sinamathele emithethweni ethile:
- Ungasebenzisi imishini kagesi (i-toothbrush, i-razor, i-dryer hair, njll).
- Hlala ebangeni elilingene kusuka ku-oven microwave, izinsimbi zensimbi namagnet.
- Ama-X ray, i-ultrasound, i-CT noma i-MRI ayikwazi ukwenza ngesikhathi sokuqapha.
- Ebusuku, ulale ebusweni bakho ukuze idivayisi ingabi ngaphansi kokucindezeleka okungokwenyama.
- Ungagqoke izingubo zangaphansi zokufakelwa noma izingubo zangaphandle.
I-Holter Monitoring Diary
Ukuqapha kwenhliziyo yeHolter akukhawulelwe ekugqokeni idivayisi. Phakathi nenqubo, isiguli sigcina idayari lapho ephawula khona:
- isikhathi somsebenzi osebenzayo kanye nomsebenzi;
- isikhathi kanye nohlobo lokuphumula;
- uhlu lwemikhiqizo yokudla kanye neziphuzo;
- sebenze ekhaya;
- umsebenzi womzimba;
- isimo somzwelo;
- ubude nekhwalithi yokulala;
- ukuthatha imithi ngokukhombisa isikhathi esiqondile; lesi sici sibaluleke kakhulu uma ukubhekwa kwe-Holter kwengcindezi yegazi kwenziwa ngokufanayo;
- Ukuba khona kwemizwa engathandeki noma ebuhlungu esifundeni senhliziyo, isizungu, isimo sangaphambili, isimo sekhanda, njll.
Ngemuva kokuphela kokuhlolwa, idivayisi isusiwe isiguli. Idatha yombhali kanye namarekhodi avela kwidayari ifakwa kukhompyutha yokucubungula, bese-ke i-cardiologist yenza izilungiso bese ebhala isiphetho.