Kev noj cov tshuaj electrocardiogram yog qhov yuav tsum tau kuaj thiab tsim nyog rau daim duab tiav ntawm tus neeg mob hauv ib qho kev kho mob. ECG tseem raug xa mus los ntawm tus kws kho mob uas tuaj koom yog tias nws xav tias muaj kev txawv txav ntawm lub plawv hauv tus neeg mob. Tab sis cov lus xaus tsis yog ib txwm qhia meej rau tus tsis yog tus kws tshaj lij.
Piv txwv li, dab tsi yog qhov ua txhaum ntawm cov txheej txheem ntawm repolarization ntawm ECG? Nws yog vim li cas? Puas yog tus kab mob ywj pheej? Yuav npaj kev kuaj mob ntxiv li cas? Qhov kev ua txhaum no tshwm sim li cas? Yuav tshuaj kho li cas? Peb yuav teb cov lus nug no thiab lwm cov lus nug tseem ceeb ntawm lub ncauj lus hauv kab lus.
Definition
Kev ua txhaum ntawm cov txheej txheem repolarization ntawm ECG yog ib lo lus kho mob nkaus xwb. Feem ntau, nws yog siv los ntawm cov kws kho mob tshwj xeeb los piav txog cov yam ntxwv ntawm electrocardiograms. Hauv qhov no, ib qho teeb meem tau pom nrog qhov kawg ntawm lub voj voog ntawm lub plawv. Qhov no yog so ntawm lub ventricles.
Qhov txawv ntawm menyuam yaus thiab cov neeg laus
Kev ua txhaumCov txheej txheem ntawm repolarization ntawm ECG tau sau tseg hauv cov menyuam yaus thiab cov neeg laus. Qhov sib txawv ntawm no yog qhov tseem ceeb: hauv cov menyuam yaus, qhov kev ua txhaum cai no feem ntau yog qhov tsis zoo. Qhov ntawd yog, nws tsis ua rau muaj kev phom sij rau tus menyuam.
Tab sis kev ua txhaum ntawm cov txheej txheem ntawm repolarization ntawm ECG nyob rau hauv cov neeg laus feem ntau yog ib qho kev qhia ntawm mob plawv: ischemia, plawv nres, myocarditis.
Focal thiab diffuse
Kev ua txhaum ntawm cov txheej txheem repolarization ntawm ECG hauv cov neeg laus tuaj yeem kaw ob qho tib si ntawm txhua ceg ntawm ECG, thiab ntawm qee qhov ntawm lawv. Hauv thawj qhov xwm txheej, muaj kev ua txhaum cai (dav dav dav), hauv qhov thib ob - focal.
Diffuse disorders ntawm repolarization txheej txheem ntawm ECG hauv cov neeg laus qhia tias pathology tau kis mus rau tag nrho lub plawv cov leeg (xws li tshwm sim, piv txwv li, nrog myocarditis). Focal ntshawv siab - ib tug pathology uas yog txwv. Hauv qhov no, tsuas yog thaj chaw tshwj xeeb ntawm lub siab cuam tshuam. Piv txwv li, Nws pob ntawv thaiv lossis rooj plaub ntawm myocardial infarction.
Kev ua txhaum ntawm cov txheej txheem repolarization txhais li cas? Tsuas yog tus kws kho plawv tuaj koom tuaj yeem muab cov lus teb tshwj xeeb rau koj.
Txoj kev khiav ntawm lub plawv dhia
focal lossis diffuse cuam tshuam ntawm cov txheej txheem repolarization tshwm sim li cas? Txhawm rau teb cov lus nug, cia peb nco qab txog lub voj voog ntawm lub plawv.
Kev cog lus ntawm peb lub plawv yog tshwm sim los ntawm hluav taws xob impulses uas tau ua rau txhua lub hlwb ntawm myocardium (peb tab tom tham txog cov leeg plawv). Tom qab xws li hluav taws xob impulse, cardiomyocytes mus txog theem ntawm contraction -kev so. Qhov kawg yog lub voj voog ntawm lub plawv.
Ib qho yuav tsum nkag siab tias tom qab txhua theem no muaj cov txheej txheem nyuaj ntawm cov poov tshuaj, calcium, chlorine ions hauv cov hlwb. Cov hluav taws xob hloov pauv hauv daim nyias nyias ntawm cardiomyocytes (lub plawv cov leeg hlwb), uas ua rau theem ntawm kev cog lus, hu ua polarization. Raws li, kev hloov hluav taws xob hauv qab cov leeg nqaij so yog twb hu ua repolarization.
Display on ECG
Qhov kev ua txhaum ntawm cov txheej txheem ntawm repolarization ntawm sab phab ntsa ntawm sab laug ventricle txhais li cas? Ntawm no, tau kawg, peb tsis txhais hais tias tam sim no ntawm ions los ntawm daim nyias nyias ntawm myocardial cells. Nws tseem tsis tau hloov qhov no hauv qhov chaw kho mob. Peb tab tom tham txog cov yam ntxwv ntawm daim duab ntawm electrocardiogram thaum lub sijhawm so ntawm lub ventricles ntawm tus neeg mob lub siab.
Ib txwm ECG yog qhov nkhaus uas muaj cov hniav:
- P - nthwv dej no qhia tias atrial contraction.
- Q, R, S - contraction of the ventricles of the heart.
- T yoj sawv cev rau kev cog lus ntawm lub plawv ventricles.
Intervals thiab ntu tuaj yeem pom ntawm cov hniav no. Dab tsi yog qhov kev txiav txim siab ntawm ECG ntawm kev ua txhaum ntawm cov txheej txheem repolarization zoo li cas? Hauv cov neeg laus thiab menyuam yaus, qhov no yuav tshwm sim los ntawm cov yam ntxwv ntawm kev hloov pauv hauv ob lub ntsiab lus: ntu ST thiab T yoj.
Yog vim li cas
Vim li cas cov txheej txheem repolarization tshwm sim ntawm ECG hauv cov hluas, cov laus, menyuam mos lossis cov neeg laus? Muaj ntau qhov laj thawj rau qhov no.
Cia sau cov ntsiab lus tseem ceeb ntawm cov kev hloov pauv no:
- Pathology, kab mob cuam tshuam rau myocardium nws tus kheej: ischemia, myocarditis, plawv nres, cov txheej txheem infiltrative.
- Siv qee yam tshuaj: quinidine, digoxin, tricyclic antidepressants, thiab ntau ntxiv.
- Qhov muaj qhov cuam tshuam ntawm electrolyte hauv cov concentration hauv lub cev ntawm cov poov tshuaj, calcium, magnesium.
- Ib tus naj npawb ntawm cov teeb meem neurogenic: hemorrhagic lossis ischemic strokes, hlwb hlav, mob hlwb raug mob.
- Metabolic ua rau: hypokalemia, hyperventilation, thiab lwm yam.
- Impaired conduction of electronic signals in the heart ventricles.
- Pathological rhythms, qhov ua rau muaj nyob hauv cov ventricles.
Raws li cov menyuam yaus, cov kab mob zoo li no tuaj yeem ua rau muaj kev cuam tshuam ntawm caj ces. Yog li ntawd, thaum lawv raug kuaj pom, tus kws kho mob tshwj xeeb kuj tseem them nyiaj rau kev kho mob syncope (ob qho tib si thaum muaj kev ntxhov siab thiab tsis muaj laj thawj), qhov muag tsis pom kev thiab cov ntaub ntawv los ntawm tsev neeg keeb kwm (keeb kwm kho mob). Yog xav tias muaj cov tsos mob hauv lub cev, ces kev kuaj caj ces raug txiav txim los txheeb xyuas cov noob caj noob ces.
Lwm yam ua rau lub plawv tsis ua haujlwm hauv cov menyuam yaus yog kis tau thiab lub plawv tsis xws luag, cardiomyopathy.
Kev Ua Phem Tseem Ceeb
Cov kab mob hauv lub hauv paus repolarization raug suav tias yog ECG hloov pauv uas tsis nyob ntawm kev ua haujlwm tsis sib haum xeeb ntawm lub ventricles. Tej zaumQhov tshwm sim ntawm ob qho tib si focal thiab diffuse cov txheej txheem pathological uas tsim kom muaj kev so ntawm lub ventricles.
Cov laj thawj yog raws li hauv qab no:
- Cov nyhuv ntawm qee yam tshuaj tau teev saum toj no.
- Electrolyte cuam tshuam.
- Heart attack, ischemia, o ntawm lub plawv cov leeg.
- Complex ntawm neurogenic yam.
kev ua txhaum cai thib ob
Kev cuam tshuam nruab nrab ntawm cov txheej txheem repolarization tsis txaus ntshai rau menyuam yaus txoj kev noj qab haus huv. Tab sis rau cov neeg laus, tshwj xeeb tshaj yog cov laus, qhov no yog ib qho kev txhawj xeeb uas yuav tsum tsis txhob ignored.
Kev cuam tshuam thib ob hauv kev rov ua dua tuaj yeem raug sau tseg. Cov no twb yog ib txwm hloov nyob rau hauv T yoj thiab ST ntu. Lawv tuaj yeem txhim kho tsuas yog vim muaj kev hloov pauv tshwj xeeb hauv cov kab ke ntawm excitation ntawm ventricles. Feem ntau, lawv yog focal nyob rau hauv cov xwm - lawv yuav pom tsuas yog nyob rau hauv ib feem ntawm ceg ntawm lub electrocardiogram.
Kev ua txhaum thib ob ntawm no yuav suav nrog cov hauv qab no:
- Hloov tus yam ntxwv ntawm pob ceg blockades.
- Kev hloov pauv hauv Wolff-Parkinson-White kab mob.
- Kev hloov pauv uas nrog rau kev ua haujlwm ntxov ntxov, ventricular rhythms thiab ventricular arrhythmias.
SRJ
Ib qho ntawm cov kab mob saum toj no yog hu ua tus mob ntawm kev rov qab ua ntej ntawm lub ventricles - ERP. Qhov sib txawv ntawm ECG tau sau tseg hauv 3-5% ntawm cov pejxeem, feem ntau yog cov hluas, ncaws pob, thiab txiv neej. Txog thaum tsis ntev los no, nws tau ntseeg tias nrog xws li ib tug syndromecov kev kwv yees zoo tshaj plaws yog ua tau. Qhov ntawd yog, kev ua txhaum cai tsis cuam tshuam rau lub neej lossis kev noj qab haus huv ntawm tib neeg.
Tab sis hnub no qhov xwm txheej txawv. Cov kev tshawb fawb tshawb fawb tau lees paub tias tus mob no ua rau muaj kev pheej hmoo ntawm kev tsim ob qho kev txaus ntshai arrhythmias thiab plawv nres feem ntau. Qhov kev pheej hmoo no tuaj yeem raug ntsuas ntawm tib lub tshuab electrocardiogram.
Cim txwv kev ua txhaum
Ua ntej tshaj plaws, peb nco qab tias qhov mob no tsis yog qhov muaj kev ywj pheej los yog kab mob. Cov no yog ECG hloov pauv uas tej zaum yuav yog tus yam ntxwv ntawm qee yam kab mob thiab kab mob. Ntxiv mus, ib tug neeg muaj peev xwm ua neej nyob ntev nrog cov kab mob zoo li no, vim lawv yuav tsis qhia lawv tus kheej nrog kev tsis txaus siab, cuam tshuam.
Yog li ntawd, tsis muaj qhov pom tseeb, tshwj xeeb ntawm kev ua txhaum ntawm cov txheej txheem rov qab ntawm ECG. Daim duab kho mob yuav tsis tshwm sim nws tus kheej kiag li. Los yog ci ntsa iab, zoo li tshwm sim nrog lub plawv nres. Yog li ntawd, tsis muaj cov tsos mob sib cais los ntawm qhov uas, yam tsis tau ua daim cardiogram, nws tuaj yeem txheeb xyuas qhov mob plawv.
Yog li ntawd, yog tias cov tsos mob ntawm cov kab mob, pathologies ntawm lub plawv tsis tshwm sim hauv ib txoj kev, kev ua txhaum cai raug kuaj pom los ntawm lub sijhawm. Hais, thaum lub sij hawm kuaj mob niaj hnub. Yog tias koj pom qhov ua txhaum ntawm kev rov ua dua vim qhov tseeb tias koj tau tig mus rau tus kws kho plawv nrog qee cov tsos mob, ces koj yuav tsum nkag siab tias lawv qhov laj thawj yog kev txhim kho ntawm ib tus kab mob tshwj xeeb.
Diagnosis
Nws tuaj yeem txiav txim siab li cas cov txheej txheem cuam tshuam ntawm kev rov ua dua tshiab? Tau kawg,siv tib yam ECG. Tus kws kho mob tshwj xeeb yuav nco ntsoov cov yam ntxwv hloov pauv hauv ntu T yoj thiab ST ntu. Raws li peb tau hais lawm, lawv tuaj yeem pom ob qho tib si ntawm txhua qhov ECG coj, thiab hauv qee qhov tshwj xeeb ntawm lawv.
Hauv qee kis, los ntawm hom hniav thiab ntu, cov kws tshaj lij tuaj yeem txiav txim siab qhov ua txhaum cai, kab mob lossis kab mob uas ua rau nws. Yog tias qhov no ua tsis tau, ces cov kev kuaj mob ntxiv hauv qab no yog tus kws kho mob sau tseg:
- kuaj ntshav kuaj. Qhov no tso cai rau koj los txiav txim seb muaj cov kab mob inflammatory uas tuaj yeem ua rau muaj teeb meem electrolyte thiab metabolic.
- Echocardiography. Qhov no yog kev kuaj ultrasound ntawm lub plawv. Nws nthuav tawm cov qauv kev hloov pauv, nrog rau kev cuam tshuam hauv myocardial contractility.
- Coronary angiography. Qhov no yog ib txoj kev tshawb nrhiav txog cov hlab ntsha coronary, uas muab lub plawv nrog cov ntshav.
cov lus qhia kho mob
Txij li cov txheej txheem cuam tshuam rov qab tsis yog ib qho kab mob ywj pheej, tab sis ib qho kev qhia ntawm qee yam kab mob, kev tsis sib haum xeeb, kab mob, ib tus neeg tsis tuaj yeem hais txog ib qho kev kho mob hauv qhov no. Txhawm rau tshem tawm qhov kev ua txhaum cai no, koj yuav tsum tau ua nrog nws qhov laj thawj. Hauv qhov no, muaj mob.
Tom qab qhov ua txhaum ntawm kev ua txhaum ntawm repolarization ntawm lub plawv ventricles raug tshem tawm, cov txheej txheem yuav rov qab mus rau qhov qub thiab yuav tsis tshwm rau ntawm ECG.
Yog tias tsis muaj cov hauv paus hauv paus hauv daim ntawv ntawm ib qho kab mob, ces cov kev kho mob hauv qab no tau muab rau kev ua txhaum cai:
- Noj cov vitamin complexes. Lawv txhawb kev ua haujlwm tag nrho ntawm lub siab,muab lub cev nrog txhua qhov tsim nyog kab thiab cov vitamins.
- Tshuaj corticotropic hormonal. Lub ntsiab active compound ntawm no yog cortisone. Nws muaj txiaj ntsig zoo rau ntau cov txheej txheem tseem ceeb hauv lub cev.
- Kev noj cov cocarboxylase hydrochloride. Nws pab kho cov metabolism hauv carbohydrate, nrog rau txhim kho trophism ntawm peripheral thiab hauv nruab nrab paj hlwb. Cov tshuaj muaj txiaj ntsig zoo rau tag nrho cov kab mob plawv tag nrho.
- Tshuaj tshuaj xws li panangin lossis anaprilin, lossis lwm yam beta-blockers.
Huab cua
Ib yam li ntawd, tsis muaj kev kwv yees thoob ntiaj teb ua tau. Nws tag nrho yog nyob ntawm cov laj thawj uas ua rau cov kev hloov pauv tau tshwm sim ntawm ECG.
Piv txwv li, tsis muaj kev hem thawj rau tus neeg mob lub neej thiab kev noj qab haus huv hauv SRCC. Thiab twb nyob rau hauv cov ntaub ntawv ntawm myocardial infarction nws yog ib qho nyuaj hais. Tseem muaj kev pheej hmoo siab uas tus neeg mob yuav nyob tsis taus. Nws yog tsis yooj yim sua kom tshem tawm qhov tshwm sim tuag nrog ib tug zoo xws li pathology.
Nyob hauv kaw
summing up, peb tuaj yeem xaus tias cov txheej txheem repolarization tsis zoo ntawm ECG tsis yog kab mob hauv lawv tus kheej. Cov no yog cov cim qhia ntawm ib qho pathology. Lawv kuj tuaj yeem ua tus mob benign uas tsis ua rau muaj kev phom sij rau tus neeg mob.
