Electrocardiogram (ECG): Qhov Kev Ntsuas Qhia Txog Dab Tsi, Nws Tsis Pom Dab Tsi, thiab Yuav Nyeem Koj Daim Ntawv Qhia Li Cas

Tus yuam sij takeaways

• Ceev thiab tsis mob: ib qho ECG 12-lead tus qauv siv sijhawm ob peb feeb thiab tsis tas siv hluav taws xob thiab tsis tas txhaj tshuaj.
• Cov xwm txheej ntawm lub suab thiab hluav taws xob yog nws lub zog: cov teeb meem plawv dhia tsis xwm yeem, lub plawv thaiv thiab ST-segment changes ntawm kev mob plawv nres uas hloov zuj zus.
• Ib qho ECG ib txwm ua rau koj ntseeg siab tab sis tsis yog qhov xaus lus: ntau tus neeg uas muaj cov hlab ntsha nqaim heev muaj cov tsos mob zoo li qub.
• Nws yog ib daim duab thaij: Kev mob plawv dhia tsis tu ncua yuav xav tau Holter lossis kev saib xyuas lub plawv dhia ntev.
• Kev txhais lus xav tau cov ntsiab lus: tib txoj kev taug qab tuaj yeem txhais tau ntau yam sib txawv ntawm tus neeg ncaws pob hnub nyoog 20 xyoo thiab tus neeg muaj hnub nyoog 65 xyoo uas muaj ntshav qab zib.

Ib nrais muag

Kuj hu ua

• ECG (kev siv Is Nrias teb thiab Askiv) thiab EKG (los ntawm German Kev kuaj mob electrocardiogram, feem ntau nyob rau hauv Tebchaws Meskas)
• 12-txhuas ECG, so ECG
• "Kev ntsuas lub plawv", "daim duab qhia lub plawv", "kev xeem ECG"
• Feem ntau tsis meej pem hauv kev sib tham nrog "echo test" (echocardiogram), uas yog kev kuaj mob sib txawv siv ultrasound

Dab tsi yog electrocardiogram

Lub plawv dhia vim yog lub teeb liab hluav taws xob uas pib hauv lub sinoatrial (SA) node, nthuav dav thoob plaws lub atria, nres ib pliag ntawm lub atrioventricular (AV) node, thiab tom qab ntawd mus rau hauv lub conduction system mus rau lub ventricles. Cov hluav taws xob no mus txog ntawm daim tawv nqaij, qhov chaw uas cov electrodes tuaj yeem khaws lawv.

Ib qho ECG 12-lead txheem siv kaum lub electrodes nplaum, rau ntawm lub hauv siab thiab plaub ntawm ob txhais ceg, los tsim kaum ob lub "pom" hluav taws xob sib txawv ntawm lub plawv. Lub tshuab luam tawm ib qho tracing nrog cov khoom uas paub tau:

• P wave: kev ua haujlwm hluav taws xob ntawm lub atria.
• QRS complex: kev ua kom hluav taws xob ntawm cov ventricles.
• T wave: kev rov qab hluav taws xob (repolarisation) ntawm cov ventricles.
• Lub Sijhawm Sib Npaug (PR, QRS lub sijhawm, QT): txhua kauj ruam siv sijhawm ntev npaum li cas, uas yog qhov uas kev ncua sijhawm ntawm kev coj mus los thiab qee cov teebmeem tshuaj tshwm sim.

Lub ECG tsuas yog sau cov cwj pwm hluav taws xob xwb. Lub electrocardiogram tsis thaij duab cov leeg nqaij plawv, cov qhov valve lossis cov hlab ntsha.

Vim li cas thiaj ua electrocardiogram

• Mob hauv siab los yog tsis xis nyob hauv siab: nrhiav kev hloov pauv uas qhia txog kev mob plawv ceev ceev, zoo dua yog tias tuaj txog hauv qhov chaw xwm txheej ceev hauv ob peb feeb xwb.
• Lub plawv dhia ceev, lub plawv dhia ceev lossis qeeb: txhawm rau piav qhia txog lub suab nrov yog tias nws muaj thaum lub sijhawm kaw suab.
• Ua tsis taus pa, tsaus muag lossis yuav luag tsaus muag: nrhiav kev thaiv kev sib txuas lus, cov qauv ua ntej kev txhawb siab, QT ntev lossis pov thawj ntawm kev ntxhov siab.
• Kab mob plawv uas paub lawm: los taug qab kev sib txuas lus, lub suab nrov thiab kev rov ua dua tshiab dhau sijhawm.
• Kev saib xyuas tshuaj: ntau yam tshuaj kho mob plawv, qee cov tshuaj tiv thaiv kev puas siab puas ntsws, qee cov tshuaj tua kab mob thiab qee cov tshuaj tiv thaiv kev ntuav cuam tshuam rau QT lub sijhawm lossis kev sib kis.
• Teeb meem electrolyte thiab raum: Qhov teeb meem potassium lossis calcium uas pom tseeb tuaj yeem hloov qhov kev ntsuas, txawm hais tias ECG tsis yog qhov hloov pauv rau kev kuaj ntshav.
• Ua ntej siv tshuaj loog lossis phais: thaum muaj hnub nyoog, cov tsos mob lossis cov kab mob plawv uas twb muaj lawm ua rau nws tseem ceeb.
• Cov txheej txheem ua ntej qee yam kev kho mob: piv txwv li ua ntej pib siv tshuaj uas paub tias ua rau lub sijhawm QT ntev dua.

Leej twg yuav tsum tau txais qhov kev xeem no

Kev kuaj ECG yog qhov tsim nyog thaum tus kws kho mob muaj lus nug tshwj xeeb txog kev ua haujlwm hluav taws xob ntawm koj lub plawv. Qhov ntawd feem ntau suav nrog cov neeg uas:

• mob hauv siab, mob siab, lossis mob kis mus rau lub puab tsaig, nraub qaum lossis caj npab, sai sai
• muaj lub plawv dhia tsis xwm yeem, lub plawv dhia tsis xwm yeem, lossis lub plawv dhia ceev/qeeb qeeb uas tau sau tseg
• tau tsaus muag, tshwj xeeb tshaj yog thaum lub sijhawm ua haujlwm tawm dag zog, lossis muaj keeb kwm hauv tsev neeg ntawm kev tuag tam sim ntawd ntawm ib tug txheeb ze hluas
• ua tsis taus pa yam tsis paub meej lossis txo qis kev ua si
• nyob nrog cov neeg uas muaj ntshav siab, ntshav qab zib, kab mob raum ntev, lossis cov kab mob plawv lossis cov hlab ntsha uas twb muaj lawm, suav nrog kab mob plawv rheumatic
• noj cov tshuaj uas tuaj yeem cuam tshuam rau lub plawv dhia lossis lub sijhawm QT, raws li tus kws kho mob qhia
• tab tom raug soj ntsuam ua ntej phais, lossis ua ib feem ntawm kev soj ntsuam kev ua si ua ntej koom nrog uas cov txheej txheem hauv zos xav tau.

Ib daim ECG so rau ib tug neeg hluas, tsis muaj tsos mob thiab tsis muaj yam ua rau muaj kev pheej hmoo feem ntau ntxiv me ntsis thiab tuaj yeem ua rau muaj lus nug txog cov kab mob tsis muaj teeb meem. Seb daim ECG kuaj mob puas muaj txiaj ntsig yog qhov kev txiav txim siab rau koj tus kws kho mob, tsis yog ib qho kev ntxiv rau niaj hnub. Cov txiaj ntsig sib txawv nyob ntawm tus neeg mob qhov xwm txheej.

Dab tsi uas lub electrocardiogram tsis tuaj yeem ntes lossis tshem tawm

Qhov no yog ib feem uas neeg nkag siab yuam kev tshaj plaws ntawm qhov kev xeem.

• Nws tsis pom cov hlab ntsha coronary. Daim ECG ib txwm nyob thaum so tsis suav nrog kab mob ntawm cov hlab ntsha hauv lub plawv, thiab tsis qhia koj seb cov hlab ntsha puas nqaim.
• Nws tsis ntsuas lub zog ntawm lub twj tso kua mis. Cov feem ntawm kev ejection yog los ntawm echocardiogram lossis cardiac MRI, tsis yog ECG.
• Nws tsis ntsuas cov valve. Qhov valve nqaim lossis xau, suav nrog kab mob rheumatic valve, yuav tsum tau kuaj echocardiography. ECG tej zaum yuav qhia cov qauv ntawm chav tsev thib ob, tab sis tsis tuaj yeem ntsuas qib ntawm lub valve.
• Nws tsis tuaj yeem zam tau qhov mob plawv nres. Kev mob plawv nres thaum ntxov lossis tsis yog ST-elevation myocardial infarction tuaj yeem muaj qhov pib tracing ib txwm lossis ze li qub. Serial ECGs ntxiv rau kev kuaj ntshav troponin siab siv, vim tias ib qho tracing tsis txaus.
• Feem ntau nws tsis nco qab cov arrhythmias sib quas ntus. Kev kaw suab 10 vib nas this tsuas yog kaw tau lub plawv dhia thaum lub sijhawm ntawd xwb. Yog tias lub plawv dhia ceev dhau thiab ploj mus, ECG ib txwm tsis suav nrog lub plawv dhia tsis xwm yeem; tej zaum yuav xav tau Holter, daim ntawv ntsuas ntev lossis kev saib xyuas xwm txheej.
• Nws tsis kuaj mob cov ntshav txhaws hauv lub ntsws ncaj qha. Kev mob ntsws embolism tej zaum yuav tsim cov qauv qhia, tab sis kev kuaj mob yog nyob ntawm kev siv duab xws li CT pulmonary angiography.
• Cov qauv ntawm lub chamber loj hlob yog indirect. Cov qauv ECG rau sab laug ventricular hypertrophy tsis yog qhov rhiab heev lossis tshwj xeeb; echocardiography ntsuas nws.
• Qee yam mob ntawm lub cev thiab caj ces tuaj yeem muaj ECG ib txwm muaj, tshwj xeeb tshaj yog thaum ntxov.

"Tsis tau txheeb xyuas" tsis zoo ib yam li "tsis suav nrog". Yog tias koj mob hauv siab, ua tsis taus pa, lub plawv dhia ceev lossis tsaus muag txawm tias koj ntsuas ECG ib txwm muaj, rov qab mus ntsib koj tus kws kho mob, tsis txhob xav tias daim ntawv qhia ib txwm muaj zoo li cov ntaub ntawv kaw.

Kev ntsuam xyuas sib txuas tab sis sib txawv

Tsis muaj ib qho kev kuaj twg uas "zoo dua" thoob plaws ntiaj teb. Qhov kev kuaj twg yuav ua ntej nyob ntawm qhov teeb meem: mob hauv siab tas li hauv chav kho mob ceev pib nrog ECG thiab troponin; feem ntau cov neeg mob lub plawv dhia tsis tu ncua yuav tsum tau saib xyuas lub plawv dhia; qhov murmur lossis xav tias muaj kab mob valve qhia txog echocardiography; mob hauv siab ruaj khov rau ib tus neeg uas muaj feem yuav mob nruab nrab feem ntau ua rau CT coronary angiography lossis functional imaging, nyob ntawm seb puas muaj thiab pab pawg neeg kho mob txiav txim siab li cas.

Yuav npaj li cas

Kev npaj rau ECG so yog qhov tsawg heev, thiab cov lus qhia tshwj xeeb yog ua haujlwm thiab teeb tsa los ntawm chav ua haujlwm. Cov lus qhia sau ntawm koj chav ua haujlwm muaj qhov tseem ceeb dua txhua yam koj nyeem hauv online.

• Khaub ncaws: hnav ib yam dab tsi uas qhib lossis tsa tau yooj yim ntawm lub hauv siab; koj yuav raug hais kom hloov mus rau hauv ib lub tsho loj.
• Daim tawv nqaij: Tsis txhob siv roj, tshuaj pleev kom noo noo, talc lossis tshuaj pleev rau ntawm lub hauv siab, caj npab thiab ceg thaum nruab hnub, vim tias cov no ua rau txo qhov kev sib cuag ntawm lub electrode. Tej zaum yuav xav tau txiav cov plaub hau hauv siab ntawm qhov chaw electrode.
• Kev yoo mov: tsis tas yuav tsum muaj rau tus qauv ECG so. Yog tias ECG yog ib feem ntawm kev sim kev ntxhov siab lossis pob dav dua, ua raws li cov txheej txheem tshwj xeeb rau qhov kev sim ntawd.
• Cov tshuaj kho mob: Nqa koj daim ntawv teev cov tshuaj uas koj siv tam sim no tuaj. Tsis txhob tsum, pib, lossis hloov cov tshuaj uas tau muab rau kev kuaj mob, suav nrog cov tshuaj beta blockers, tshuaj antiarrhythmics lossis tshuaj thyroid, tshwj tsis yog tus kws kho mob uas tau muab tshuaj rau koj hais kom koj ua.
• Stimulants: Rau kev kuaj ECG thaum so, caffeine thiab nicotine tsis yog ib qho teeb meem kiag li, tab sis lawv tuaj yeem ua rau lub plawv dhia ceev thiab ua rau lub plawv dhia tsis zoo. Yog tias qhov kev kuaj no tau ua tshwj xeeb los ntsuas qhov mob plawv dhia ceev lossis rau kev kuaj kev ntxhov siab, ua raws li cov lus qhia ntawm lub tshuab.
• Qhia rau cov neeg ua haujlwm yog tias koj muaj lub tshuab ua pacemaker lossis lub tshuab defibrillator uas tau cog rau hauv koj lub cev, kev mob plawv lossis kev phais bypass yav dhau los, cov qhov txhab hauv siab lossis cov ntaub qhwv, lossis yog tias koj tau muaj kev kuaj zoo sib xws ua ntej, kev taug qab yav dhau los muaj txiaj ntsig zoo rau kev sib piv.

Cev xeeb tub

Kev siv ECG tsis muaj kev siv hluav taws xob thiab siv thaum cev xeeb tub thaum pom tias muaj mob. Qhov chaw yuav hloov kho tau, pw ncaj nraim rau nraub qaum thaum cev xeeb tub tom qab yuav ua rau koj lub taub hau kiv taub hau, yog li ntawd feem ntau siv txoj hauj lwm tig sab laug lossis ib nrab sawv ntsug. Qee qhov kev hloov pauv ECG, suav nrog kev hloov pauv ntawm txoj kab thiab kev hloov pauv me me ntawm T-wave, feem ntau tshwm sim thaum cev xeeb tub thiab xav tau tus kws kho mob txhais lus uas paub txog kev cev xeeb tub.

Cov me nyuam

Cov ECG rau menyuam yaus siv cov electrodes me dua thiab, qhov tseem ceeb, cov nqi ib txwm muaj raws li hnub nyoog, cov qauv ntawm cov neeg laus nyeem tsis raug cov menyuam yaus cov cim qhia. Kev piav qhia cov ntawv nplaum ua ntej yuav pab tau; kev txav mus los thiab kev quaj feem ntau ua rau muaj qhov tsis zoo, yog li ntawd yuav tsum tau kaw dua.

Cov neeg laus thiab cov neeg uas muaj kev txwv tsis pub txav mus los

Cov tawv nqaij uas tsis khov los yog nyias yuav ua rau cov nplaum lo, thiab kev tshee hnyo los yog tus kab mob Parkinson tuaj yeem ua rau muaj qhov tsis zoo li qub. Qhia rau tus kws kho mob yog tias pw tiaj tiaj nyuaj; kev kaw suab ib nrab pw tuaj yeem sau ua ntawv sau.

Cov neeg uas muaj lub tshuab pacemakers lossis cov khoom siv implanted

Lub ECG muaj kev nyab xeeb nrog cov pacemakers thiab implantable defibrillators thiab feem ntau yog siv los xyuas qhov ua haujlwm ntawm lub cuab yeej. Ib txwm hais txog lub cuab yeej, vim tias qhov kev taug qab tau txhais txawv. Kev nug txog lub cuab yeej tshwj xeeb los ntawm pab pawg kws kho mob plawv muab cov ntaub ntawv uas ECG saum npoo tsis tuaj yeem ua tau.

Kab mob ntshav qab zib, kab mob raum ntev thiab kab mob plawv tsis ua haujlwm

Tsis tas yuav npaj tshwj xeeb rau kev kuaj ECG thaum so, thiab tsis tas yuav txwv dej lossis yoo mov. Yog tias koj qhov ECG yog ib feem ntawm kev kuaj kev ntxhov siab, cov lus qhia txog kev yoo mov thiab tshuaj rau qhov kev kuaj ntawd tuaj yeem cuam tshuam rau cov neeg uas noj insulin lossis lwm yam tshuaj txo cov piam thaj, cov neeg uas txwv dej, thiab cov neeg uas muaj kab mob raum lossis lub plawv tsis ua haujlwm, nug tus kws kho mob uas thov kom tau cov lus qhia tshwj xeeb ua ntej koj yoo mov lossis hla ib koob tshuaj.

Yuav ua li cas thaum lub sijhawm electrocardiogram

• Txoj Haujlwm: koj pw saum lub rooj zaum thiab nthuav tawm lub hauv siab, dab teg thiab pob luj taws. Koj tuaj yeem thov kom muaj kev ceev ntiag tug thiab tus neeg saib xyuas.
• Electrode qhov chaw: kaum lub electrodes nplaum tau muab tso rau ntawm qhov chaw uas tau teev tseg. Qhov chaw raug yog qhov tseem ceeb; cov xov hlau tsis nyob hauv qhov chaw yog qhov ua rau muaj cov kab txawv txawv.
• Cov ntaubntawv: koj pw twj ywm, ua pa li qub thiab tsis txhob tham lus ob peb feeb thaum lub tshuab kaw suab. Kev tshee hnyo, hnoos lossis txav mus los tuaj yeem ua rau qhov kev taug qab tsis meej, thiab tus kws kho tshuab yuav rov ua dua.
• Tom qab ntawd: cov electrodes raug tev tawm. Daim tawv nqaij liab me ntsis lossis nplaum me ntsis yog qhov tshwm sim. Kev ua ub ua no ib txwm, kev noj mov thiab kev tsav tsheb tuaj yeem rov pib dua tam sim ntawd, tshwj tsis yog tias qhov laj thawj ntawm kev xeem nws tus kheej ua rau muaj kev txwv.

Cov txheej txheem siv sijhawm ntev npaum li cas

Feem ntau cov ntaub ntawv hluav taws xob tsuas yog siv li 10 vib nas this xwb. Kev tso lub electrode, kev tso qhov chaw, thiab kev tshem khaub ncaws/hnav khaub ncaws txhais tau tias lub sijhawm teem tseg feem ntau yuav siv sijhawm 5-10 feeb, thiab ntev dua yog tias xav tau kev kuaj xyuas dua, yog tias yuav tsum txiav cov plaub hau hauv siab, lossis rau cov menyuam yaus. Hauv chav kho mob ceev uas muaj mob hauv siab, lub hom phiaj yog kom muaj kev kuaj xyuas thiab tshuaj xyuas hauv ob peb feeb tom qab tuaj txog. Hauv qhov chaw ceev, tus kws kho mob yuav tshuaj xyuas qhov kev kuaj xyuas tam sim ntawd; rau kev kuaj mob sab nraud, lub sijhawm tshaj tawm nyob ntawm chav ua haujlwm.

Nkag siab txog koj daim ntawv qhia ECG

Feem ntau daim ntawv qhia txog ECG muaj peb ntu: cov ntawv luam tawm, cov kev ntsuas uas tshuab tsim, thiab kev txhais lus los ntawm tib neeg.

• Lub plawv dhia ceev: qhia ua cov neeg ntaus ib feeb. Cov nqi qis dua lossis siab dua li cov neeg laus ib txwm muaj tsis yog qhov tsis zoo li qub, cov neeg ncaws pob uas tau kawm tiav feem ntau muaj kev so qeeb, thiab kev ntxhov siab, kub taub hau, mob, ntshav tsis txaus lossis lub cev qhuav dej feem ntau ua rau tus nqi nce.
• Atherosclerosis: "sinus rhythm" txhais tau hais tias lub plawv dhia pib nyob rau hauv qhov chaw ib txwm. Atrial fibrillation, atrial flutter, supraventricular tachycardia thiab ventricular arrhythmias tau piav qhia los ntawm lub npe.
• Kev ncua sijhawm: Lub sijhawm PR (AV conduction), QRS duration (ventricular conduction, ntev hauv bundle branch block), thiab QT/QTc (repolarisation, cuam tshuam rau qee cov tshuaj thiab cov mob uas tau txais los ntawm noob caj noob ces).
• Axis thiab voltages: kev coj thiab qhov loj ntawm cov zog hluav taws xob. Cov qauv hluav taws xob rau hypertrophy tsis txhim khu kev qha ntawm lawv tus kheej thiab raug cuam tshuam los ntawm lub cev tsim, phab ntsa tuab ntawm lub hauv siab thiab qhov chaw tso cov hlau lead.
• ST ntu thiab T nthwv dej: ST nce lossis poob qis thiab T-wave inversion tej zaum yuav qhia txog ischaemia lossis raug mob, tab sis kuj tshwm sim nrog pericarditis, myocarditis, electrolyte disturbance, bundle branch block, early repolarisation variants thiab left ventricular hypertrophy.
• Q nthwv dej: tej zaum yuav qhia tau tias muaj mob plawv qub, kho tau zoo lawm, lossis tej zaum yuav nyob rau qhov chaw thiab tsis muaj teeb meem.

Lub tshuab cov lus hais tsis siv neeg nyob rau sab saum toj ntawm cov ntawv luam tawm, cov kab lus xws li "ECG tsis zoo li qub", "tej zaum yuav muaj kev puas tsuaj qub", "tsis yog qhov tshwj xeeb T-wave abnormality" lossis "xav txog sab laug ventricular hypertrophy", yog lub tswv yim ntawm lub computer, tsis yog kev kuaj mob. Cov kev nyeem ntawv tsis siv neeg feem ntau raug hu ntau dhau thiab feem ntau kho los ntawm tus kws kho mob uas tshaj tawm. Tsis txhob ua raws li cov lus hais luam tawm ua ntej tus kws kho mob tau txhais cov kev taug qab hauv cov ntsiab lus ntawm koj cov tsos mob, kev kuaj mob, cov yam txaus ntshai thiab ECG yav dhau los. Kev sib piv nrog cov kev taug qab qub feem ntau hloov lub ntsiab lus tag nrho: qhov kev tshawb pom ruaj khov tsis txhawj ntau dua li qhov tshiab.

Thaum cov txiaj ntsig ECG tuaj yeem ua rau yuam kev

Cov kev tshawb pom uas yuav zoo li tsis zoo li qub

• Kev hloov pauv ntawm cov hlau lead lossis cov hlua ceg uas hloov pauv tsis raug tuaj yeem ua raws li cov kab mob plawv qub, hloov pauv axis lossis txawm tias qhia txog dextrocardia.
• Kev txav mus los, tshee hnyo, tshee hnyo lossis cov electrodes xoob tuaj yeem ua raws li arrhythmia lossis tsim cov qauv pib uas taug kev.
• Kev cuam tshuam hluav taws xob los ntawm cov khoom siv nyob ze tuaj yeem npog cov khoom cuav uas zoo li flutter lossis fibrillation.
• Cov qauv ib txwm muaj xws li kev rov ua dua tshiab thaum ntxov, sinus arrhythmia nrog kev ua pa, thiab kev hloov pauv ntsig txog kev ncaws pob feem ntau raug cim tias "txawv txawv" los ntawm software.
• Kev coj cwj pwm ntawm lub cev, cov nqaij ntawm lub mis, kev rog dhau, lub ntsws ua pa ntau dhau lossis oedema hloov cov voltages thiab ST-T tsos.
• Kev thaiv ceg ntoo ua ke, kev sib zog thiab kev ua ntej kev txhawb nqa ua rau cov ntu ST tsis sib xws, ua rau kev ntsuam xyuas ischemia tsis ntseeg tau los ntawm ECG ntawm qhov chaw ib leeg.
• Kev cuam tshuam ntawm electrolyte thiab metabolic: potassium, calcium thiab magnesium tsis zoo li qub, thiab qee cov tshuaj tuaj yeem ua rau muaj kev hloov pauv ST-T thiab QT uas tsis cuam tshuam rau kab mob plawv.

Cov kev tshawb pom uas zoo li tsis zoo li qub lossis ua rau neeg ntseeg siab

• Mob plawv thaum ntxov: thawj qhov kev taug qab tuaj yeem yog qhov ib txwm muaj. Rov ua dua ECGs thiab kev kuaj troponin yog qhov tseem ceeb yog tias cov tsos mob qhia txog tus mob plawv nres sai sai.
• Kev puas tsuaj ntawm thaj chaw sab nraud lossis sab nraud tuaj yeem ua kom pom tseeb ntawm tus qauv 12 leads.
• Cov mob plawv dhia tsis tu ncua ploj ntawm cov ntu, yog li qhov kev taug qab so zoo li qub.
• Kab mob plawv ruaj khov feem ntau tsim cov ECG so ib txwm txawm tias muaj qhov nqaim heev.
• Kev tsis sib haum xeeb ntawm lub cev los yog lub suab paj nruag uas tsis muaj zog tuaj yeem npog cov kev hloov pauv ischemic tshiab.

Vim li no, tus kws kho mob yuav tsum ntsuas ECG piv rau koj zaj dab neeg. Cov tsos mob uas kav ntev lossis hnyav zuj zus zoo dua li kev taug qab ib txwm muaj.

Kev Pheej Hmoo thiab Kev Nyab Xeeb

Kev so ECG 12-lead

Ib qho ECG so kaw cov teeb liab hluav taws xob; nws tsis xa hluav taws xob mus rau hauv lub cev, tsis siv hluav taws xob thiab tsis tas yuav txhaj tshuaj. Cov teeb meem ua tau yog me me: daim tawv nqaij liab ib ntus lossis khaus los ntawm cov nplaum, tsis xis nyob me ntsis thaum tshem cov ntaub qhwv, tsis xis nyob los ntawm kev txiav cov plaub hau hauv siab, thiab tsis tshua muaj kev tsis haum tshuaj ntawm daim tawv nqaij. Qhov kev pheej hmoo tseem ceeb hauv kev kho mob tsis yog lub cev tab sis yog kev txhais lus, kev nyeem tsis raug lossis kev txhais lus ntau dhau tuaj yeem ua rau muaj kev ntxhov siab tsis tsim nyog thiab kev kuaj ntxiv, lossis ua rau muaj kev ntseeg siab cuav.

Kev tawm dag zog (kev ntxhov siab) ECG

Ib qho ECG kev ntxhov siab muaj qhov sib txawv thiab muaj kev pheej hmoo siab dua, vim nws txhob txwm ua rau lub plawv ua haujlwm ntau ntxiv. Cov xwm txheej tsis tshua muaj tab sis paub zoo suav nrog mob hauv siab, arrhythmia, ntshav siab hloov pauv, tsaus muag thiab, tsis tshua muaj, cov xwm txheej plawv loj. Nws ua tiav nrog kev saib xyuas kho mob thiab cov chaw cawm siav, thiab nws tsis haum rau txhua tus, piv txwv li thaum xav tias muaj mob plawv loj, mob aortic stenosis hnyav lossis arrhythmia tsis tswj tau. Cov lus qhia txog kev nyab xeeb rau ECG so tsis hloov mus rau kev sim kev ntxhov siab.

Kev soj ntsuam Holter thiab kev taug kev

Kev pheej hmoo tsuas yog txwv rau kev khaus ntawm daim tawv nqaij los ntawm kev sib cuag ntev ntawm lub electrode thiab qhov tsis yooj yim ntawm kev hnav lub cuab yeej. Kev kuaj mob tau zoo nyob ntawm seb cov tsos mob tshwm sim ntau npaum li cas thaum lub sijhawm saib xyuas.

Cov xwm txheej tshwj xeeb

Cev xeeb tub

Kev dhia ceev thiab ua tsis taus pa yog ib qho uas tshwm sim ntau thaum cev xeeb tub, thiab ECG yog thawj kauj ruam uas tsim nyog, tsis muaj kev siv hluav taws xob. Kev hloov pauv ntawm lub cev hloov pauv qhov kev taug qab, yog li kev txhais lus txog kev cev xeeb tub tseem ceeb. Kab mob rheumatic valve uas tshwm sim thawj zaug thaum cev xeeb tub yog qhov tseem ceeb hauv Is Nrias teb, thiab feem ntau xav tau echocardiography es tsis yog ECG ib leeg xwb.

Cov menyuam yaus thiab tub ntxhais hluas

Cov ntaub ntawv kuaj mob rau menyuam yaus yuav tsum tau nyeem raws li cov nqi tshwj xeeb rau hnub nyoog. Kev tshawb nrhiav yog qhov tsim nyog rau kev tsaus muag thaum lub sijhawm ua si, lub plawv dhia ceev ceev nrog kev poob qis, lossis keeb kwm tsev neeg ntawm kev tuag tam sim ntawd ntawm ib tug txheeb ze hluas. Kev ntsuam xyuas kab mob plawv txij thaum yug los vam khom echocardiography, nrog rau ECG ua qhov kev xeem txhawb nqa.

Cov laus

Cov kab mob atrial fibrillation thiab conduction disease feem ntau tshwm sim thaum muaj hnub nyoog, thiab cov kab mob plawv feem ntau tshwm sim yam tsis muaj mob hauv siab, nrog rau kev ua pa tsis taus, tsis meej pem lossis qaug zog. Cov kab mob qub feem ntau qhia txog ntau yam kev txawv txav uas muaj nyob ua ke, yog li kev sib piv nrog ECGs yav dhau los yog qhov tseem ceeb heev.

Mob ntshav qab zib

Kab mob plawv tuaj yeem loj dua thiab tsis tshua muaj tsos mob rau cov neeg uas muaj ntshav qab zib ntev, yog li ntawd, tsis txhob xav tias ECG ib txwm muaj. Tham txog tej yam tsos mob ntawm kev ua haujlwm, txawm tias tsis hnyav heev los xij, nrog koj tus kws kho mob tham.

Kab mob raum ntev thiab kev ntxuav ntshav

Kev hloov pauv ntawm cov potassium thiab calcium thaum lub sijhawm ntxuav ntshav tuaj yeem hloov qhov kev taug qab, thiab kev loj hlob ntawm cov hlab ntsha sab laug yog qhov tshwm sim ntau. Kev hloov pauv ntawm ECG yog qhov qhia tau tab sis tsis hloov qhov kev kuaj biochemical rau kev cuam tshuam ntawm electrolyte.

Lub plawv tsis ua haujlwm

Lub ECG pab txheeb xyuas cov teeb meem ntawm lub plawv dhia thiab kev ncua sij hawm ntawm lub plawv dhia xws li kev thaiv ceg ntawm sab laug, uas cuam tshuam rau cov khoom siv thiab kev txiav txim siab kho mob. Nws tsis ntsuas qhov feem pua ​​​​​​ntawm kev ejection; echocardiography thiab kev kuaj natriuretic peptide ua haujlwm rau lub hom phiaj ntawd.

Ncaws pob

Kev cob qhia ua rau pom cov kev hloov pauv ECG, suav nrog qhov qeeb qeeb thiab cov hluav taws xob nce ntxiv, uas tsis yog kab mob. Kev sib txawv ntawm cov no los ntawm cardiomyopathy lossis channelopathy xav tau cov qauv tshwj xeeb ntawm cov neeg ncaws pob thiab feem ntau yog kev thaij duab ntxiv.

Lub electrocardiogram hauv cov ntsiab lus Indian

• muaj: Cov tshuab ECG yog cov khoom siv kuaj mob uas muaj ntau tshaj plaws hauv Is Nrias teb, muaj nyob rau hauv cov tsev kho mob hauv nroog, cov chaw kho mob me, cov chaw kuaj mob thiab ntau lub chaw kho mob thawj zaug. Qhov no ua rau ECG yog thawj qhov kev ntsuam xyuas hluav taws xob hauv nroog thiab thaj chaw nyob deb nroog.
• Hom lus thiab lub npe: Cov neeg mob feem ntau siv "ECG" thiab "echo test" sib pauv tau, tab sis cov no yog kev kuaj mob sib txawv, ECG sau cov hluav taws xob, echo siv ultrasound los thaij duab cov qauv thiab kev ua haujlwm. Piav qhia meej tias qhov twg tau thov.
• Rheumatic mob plawv tseem yog ib qho tseem ceeb ua rau muaj kab mob valve hauv Is Nrias teb, tshwj xeeb tshaj yog rau cov neeg hluas. Nws yuav qhia tau tias atrial fibrillation lossis chamber loj hlob ntawm ECG, tab sis kev kuaj mob thiab kev ntsuas qib yuav tsum tau echocardiography.
• Kab mob plawv thaum yau: Cov neeg Esxias Qab Teb feem ntau muaj kab mob plawv sai dua thiab qis dua li lwm cov pej xeem. Tsuas yog hnub nyoog xwb yuav tsum tsis txhob txo qhov kev txhawj xeeb, thiab ECG ib txwm nyob thaum so yuav tsum tsis txhob hloov pauv keeb kwm ntawm cov tsos mob uas ntseeg tau.
• Kab mob ntshav tsis txaus, suav nrog kev tsis txaus hlau thiab thalassemia tus cwj pwm, yog kis tau dav thiab tuaj yeem ua rau lub plawv dhia ceev, ua tsis taus pa thiab lub plawv dhia ceev, cov tsos mob uas yuav ua rau ECG. Yuav tsum tau kuaj ntshav ua ke.
• Lub qog ua kom mob siab yog ib qho ua rau mob atrial fibrillation lossis sinus tachycardia uas tshwm sim ntau zaus, uas kho tau los ntawm kev kuaj pom ntawm ECG.
• Tele-ECG thiab cov saw hlau xa mus rau lwm tus: ntau lub chaw me me xa cov ntaub ntawv rau kev tshaj tawm hauv online. Nqa daim ntawv luam tawm thawj lossis daim duab meej mus rau txhua qhov kev sab laj, kev sib piv ua ntu zus yeej hloov pauv kev txhais lus.
• Cov pob khoom kuaj mob feem ntau muab ib lub ECG so. Cov lus hais tsis raug ntawm lub tshuab los ntawm cov pob no yog ib qho laj thawj feem ntau rau kev ntxhov siab; coj qhov kev taug qab mus rau kws kho mob es tsis txhob tshawb nrhiav cov lus hauv online.
• Cov ntaub ntawv ntiag tug: Cov ntaub ntawv ECG thiab cov ntawv qhia yog cov ntaub ntawv kev noj qab haus huv ntawm tus kheej. Raws li Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023, txhua daim ntawv digital, portal lossis app uas sau koj cov ntaub ntawv yuav tsum qhia rau koj paub tias muaj dab tsi sau thiab vim li cas, thiab thov koj txoj kev tso cai.

Tus nqi thiab kev pov hwm, thiab dab tsi cuam tshuam rau tus nqi hauv Is Nrias teb

Ib qho ECG uas siv 12-lead so yog ib qho ntawm cov kev kuaj mob plawv uas pheej yig tshaj plaws hauv Is Nrias teb, feem ntau pheej yig dua li echocardiogram, kev kuaj mob treadmill lossis CT coronary angiography. Cov nqi sib txawv ntawm ib lub tsev kho mob me, ib lub chaw kuaj mob thiab ib lub tsev kho mob loj, thiab ntawm cov nroog.

Cov yam uas cuam tshuam rau qhov koj them:

• Hom chaw, chav kuaj mob uas sawv ntawm nws tus kheej, tsev laus, tsev kho mob hauv tuam txhab lossis lub koom haum tsoomfwv
• Lub nroog thiab thaj chaw
• Txawm hais tias ECG yog ib qho khoom siv los yog muab tso rau hauv kev kuaj mob lossis pob khoom ua ntej phais
• Seb puas muaj tus nqi them rau tus kws kho mob plawv sib cais ntxiv rau qhov kev kaw suab?
• Txawm tias qhov kev kuaj ntawd ua nyob rau hauv chav kho mob ceev lossis ua tus neeg mob pw hauv tsev kho mob, qhov twg nws yuav yog ib feem ntawm cov pob khoom kho mob dav dua
• Cov kev pab cuam ECG sab nraum lub sijhawm ua haujlwm, kev pabcuam pw ntawm ib lub txaj lossis kev pabcuam sau ECG hauv tsev
• Cov khoom ntxiv xws li rov ua dua lossis ua ntu zus, cov ntawv qhia suab paj nruag lossis kev saib xyuas Holter tom qab

Txog kev pov hwm: kev kuaj mob sab nraud feem ntau tsis raug them rau hauv kev pov hwm kev noj qab haus huv tus qauv tshwj tsis yog tias daim ntawv pov hwm suav nrog OPD lossis kev pab kuaj mob. Thaum ua ECG thaum lub sijhawm nkag mus pw hauv tsev kho mob, nws feem ntau yog ib feem ntawm qhov kev thov. ECGs ua ntej ua haujlwm, kev pov hwm-kev kho mob thiab daim ntawv pov thawj kev noj qab haus huv feem ntau yog them los ntawm tus neeg thov lossis tus tswv ntiav haujlwm. Paub meej tias kev them nqi nrog koj tus neeg pov hwm lossis lub rooj pov hwm ntawm tsev kho mob ua ntej qhov kev xeem.

Cov lus dab neeg thiab qhov tseeb

Lus nug cov lus nug

Txawm tias kuv cov hlab ntsha raug thaiv los, ECG puas tuaj yeem ua tau li qub?

Yog. Daim ECG so tsis thaij duab cov hlab ntsha hauv lub plawv, thiab ntau tus neeg uas muaj qhov nqaim heev muaj cov duab zoo li qub ntawm cov ntu mob. Yog tias koj mob hauv siab thaum ua haujlwm lossis ua tsis taus pa, koj tus kws kho mob tseem yuav pom zoo kom kuaj xyuas kev ua haujlwm lossis CT coronary angiography txawm tias ECG zoo li qub.

Kuv daim ntawv qhia hais tias "kev hloov pauv ST-T uas tsis tshwj xeeb". Kuv puas yuav tsum txhawj?

Kab lus no txhais tau hais tias tus qauv repolarisation tsis yog phau ntawv ib txwm muaj tab sis tsis taw qhia rau kev kuaj mob tshwj xeeb. Cov ua rau muaj xws li lub cev tsim kho, qhov chaw muaj cov hlau lead, kev hloov pauv electrolyte, tshuaj thiab cov kev hloov pauv ib txwm muaj. Nws xav tau kev tshuaj xyuas nrog rau koj cov tsos mob, cov yam ntxwv txaus ntshai thiab txhua qhov kev taug qab yav dhau los, es tsis txhob txhais ib leeg.

Qhov txawv ntawm ECG thiab Holter monitor yog dab tsi?

Ib qho ECG txheem kaw tau kwv yees li kaum vib nas this ntawm lub plawv dhia, yog li nws tsuas kaw tau qhov xwm txheej thaum ntawd xwb. Lub Holter lossis daim ntawv ntsuas kaw tau tas li rau ib hnub mus rau ob peb lub lis piam, uas zoo dua rau kev mob plawv dhia ceev, tsaus muag lossis xav tias muaj mob plawv dhia tsis tu ncua uas tuaj thiab mus.

Lub sijhawm teem sijhawm ECG tag nrho siv sijhawm ntev npaum li cas?

Cov ntaub ntawv hluav taws xob nws tus kheej kav li kaum vib nas this. Kev tso cov hluav taws xob, kev teeb tsa thiab kev hnav khaub ncaws feem ntau ua rau tag nrho kev mus ntsib tsib txog kaum feeb. Nws tuaj yeem siv sijhawm ntev dua rau cov menyuam yaus, yog tias xav tau kev rov ua dua vim yog kev txav mus los, lossis yog tias cov plaub hau hauv siab xav tau txiav ua ntej.

Puas yog ECG mob lossis siv hluav taws xob?

Ib qho ECG so tsis siv hluav taws xob, tsis muaj koob thiab tsis muaj qhov sib piv. Cov electrodes tsuas yog lo rau ntawm daim tawv nqaij xwb. Cov neeg feem coob tsis hnov ​​dab tsi tsuas yog rub me ntsis thaum cov ntaub nplaum raug tev tawm, thiab qee zaum daim tawv nqaij liab lossis khaus ntawm cov electrode.

Puas muaj kev nyab xeeb rau kev siv ECG yog tias kuv muaj lub tshuab pacemaker?

Yog, thiab feem ntau nws yog ua tshwj xeeb los xyuas seb lub tshuab pacemaker ua haujlwm li cas. Qhia rau tus kws kho mob txog txhua yam khoom siv uas tau cog rau hauv, vim tias cov kev ntsuas paced nyeem txawv. Kev nug cov khoom siv raug cai los ntawm pab pawg kws kho mob plawv muab cov ntaub ntawv qhia txog ECG ntawm qhov chaw.