CN102551707B - Method for placing electrodes when standard 12 lead electrocardiogram machine is used for detecting fetal electrocardiogram - Google Patents
Method for placing electrodes when standard 12 lead electrocardiogram machine is used for detecting fetal electrocardiogram Download PDFInfo
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- 230000001605 fetal effect Effects 0.000 title claims abstract description 53
- 238000000034 method Methods 0.000 title claims abstract description 19
- 210000001364 upper extremity Anatomy 0.000 claims abstract description 14
- 210000003815 abdominal wall Anatomy 0.000 claims abstract description 10
- 210000002784 stomach Anatomy 0.000 claims description 29
- 208000007502 anemia Diseases 0.000 claims description 24
- 210000003141 lower extremity Anatomy 0.000 claims description 14
- 238000012360 testing method Methods 0.000 claims description 12
- 210000000481 breast Anatomy 0.000 claims description 7
- 239000007788 liquid Substances 0.000 claims description 6
- LFQSCWFLJHTTHZ-UHFFFAOYSA-N Ethanol Chemical compound CCO LFQSCWFLJHTTHZ-UHFFFAOYSA-N 0.000 claims description 4
- 210000001113 umbilicus Anatomy 0.000 claims description 4
- 230000033764 rhythmic process Effects 0.000 description 17
- 238000001514 detection method Methods 0.000 description 16
- 230000005611 electricity Effects 0.000 description 15
- 210000003414 extremity Anatomy 0.000 description 9
- 239000000203 mixture Substances 0.000 description 5
- 210000003754 fetus Anatomy 0.000 description 4
- 210000000038 chest Anatomy 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 238000010586 diagram Methods 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 238000012544 monitoring process Methods 0.000 description 3
- 238000012545 processing Methods 0.000 description 3
- 230000000747 cardiac effect Effects 0.000 description 2
- 238000011161 development Methods 0.000 description 2
- 230000008774 maternal effect Effects 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 210000000689 upper leg Anatomy 0.000 description 2
- 230000003187 abdominal effect Effects 0.000 description 1
- 230000003190 augmentative effect Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 238000009826 distribution Methods 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000005622 photoelectricity Effects 0.000 description 1
- 239000002243 precursor Substances 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 238000011160 research Methods 0.000 description 1
- 208000024891 symptom Diseases 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 210000000779 thoracic wall Anatomy 0.000 description 1
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/344—Foetal cardiography
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Abstract
Provided is a method for placing electrodes when a standard 12 lead electrocardiogram machine is used for detecting fetal electrocardiogram. The method is mainly characterized in that (1) a right upper limb electrode VR, a left upper limb electrode VL and a left leg electrode VF are adhered on an abdominal wall above public symphysis, an abdominal wall above fundus and a side abdominal wall; (2) a right leg electrode RL is adhered on a convenient portion of an abdominal wall; and (3) six chest lead electrodes C1, C2, C3, C4, C5 and C6 are respectively adhered at vertexes of a regular hexagon of the surface of the abdominal wall of a pregnant woman, the center of the regular hexagon is a middle point of a connecting line between the electrode of the abdominal wall above the public symphysis and the abdominal wall above the fundus or is the location point of the navel of the pregnant woman, simultaneously, the two vertexes of the regular hexagon are on the vertical and horizontal symmetry and at the left and right direction which are penetrate the central point, and the diameter of a circumcircle of the regular hexagon is about 20cm. In the electrode placing scheme, the standard 12 lead electrocardiogram machine can stably record the fetal electrocardiogram with high signal to noise ratio and is dual-purpose, so that cost of hospitals is saved.
Description
Technical field
The application relates to a kind of laying method of electrode while by standard 12, leading electrocardiograph detection fetal rhythm electricity.
It is the have an electro-cardiogram electrocardiograph of common use while checking of adult that standard 12 is led electrocardiograph.The electrocardiogram of doing for the ease of same patient's different times compares, and according to its standard, during measurement, at adult's body surface, lays 10 electrodes, be respectively---right upper extremity electrode VR, left upper extremity electrode VL, right lower limb electrode RL, left lower limb electrode VF, 6 chest electrode C1, C2, C3, C4, C5, C6; Based on these electrode measurements and synthesize 12 lead electrocardiosignal---I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6.If represent the potential value at its body surface position, respective electrode place by the numbering of each electrode, the synthesis mode of standard 12 lead signals is as follows:
(1) standard limb lead: leads I=VL-VR; Leads I I=VF-VR; Leads I II=VF-VL;
(2) augmented limb lead: aVR=VR-(VL+VF)/2; AVL=VL-(VR+VF)/2; AVF=VF-(VL+VR)/2;
(3) chest lead: breast is led Vi=Ci-(VR+VL+VF)/3, i=1 ..., 6.
Standard 12 is led electrocardiograph while realizing in inside, actual only with detecting independently lead signals of 8 tunnels, comprises the accurate limb lead signal of 2 road sign and 6 tunnel chest lead signals; Other 4 tunnel lead signals, go out by formula to calculating by this 8 tunnel lead signals.And, in realize inside, right upper extremity electrode, left upper extremity electrode and left lower limb electrode add that by every wire the resistance in 5000 Europe links together, node is called " central electric terminal ", as the reference ground of analog circuit; Right lower limb electrode is connected to analog references ground or the driven-right-leg circuit of electrocardiograph internal circuit, with the common-mode voltage of eliminating human body, disturbs.When standard 12 is led the actual detection of electrocardiograph adult electrocardiogram, 4 limb conductive electrode are all used electrode holder usually, and 6 breast conductive electrode are usually all used and inhaled the ball electrode or all use SMD electrode.
Lead the machine of electrocardiograph by standard 12 and measure Fetal ECG, standard the put method of its 10 electrodes when the placement of parent body surface becomes people detection certainly should be different to some extent, and the present invention is exactly a scheme of how to place at the parent body surface about it.
Background technology
At present, at parent body surface detection Fetal ECG, all use custom-designed fetal electrocardiograph to carry out both at home and abroad.The fetal electrocardiograph that singly leads that uses 3 electrode detection 1 road signals is arranged, as the fetal electrocardiograph FECG-D of the productions such as front Zhejiang Institute of Computing Technology exploitation in 2000, Guangdong Ke Meien group; Also have and adopt the more multi-lead fetal electrocardiograph of multi-electrode detection multiple signals, obtain 4 tunnel lead signals as the product G Y-EXPL of Huanan Medical Electrical Tech Co., Ltd., Henan is used 6 electrodes, the Wireless Fetal Electrocardiogram Monitoring System based on S3C2410 of Fudan University's development adopts 4 electrodes to obtain 2 tunnel lead signals.From standard 12, to lead electrocardiograph different on number of electrodes for existing custom-designed fetal electrocardiograph, realize in inside that also to lead electrocardiograph different from standard 12, and no longer there be " central electric terminal " in inside.
At present, also do not see by standard 12 and lead the report that electrocardiograph detects Fetal ECG.Possible reason is: (1) clinically, electrode is placed by 12 beacons are accurate at anemia of pregnant woman's body surface, when the routine of 4 limb conductive electrode and 6 breast conductive electrode is placed, in the standard 12 tunnel lead signals of acquisition, is difficult for seeing fetal electrocardiogram; (2) when the related personnel wants to change the electrode laying method, do not know how 10 electrodes are placed, and particularly 4 clip limb conductive electrode do not know how to process, the inside that standard 12 is led electrocardiograph is after all realized with special-purpose fetal electrocardiograph different; (3) related personnel guesses that Fetal ECG is too small with respect to the parent electrocardio, with 12, lead the adult electrocardiogram machine and does not certainly detect the fetal rhythm electricity, thereby just nobody does test.If can lead electrocardiograph detection record Fetal ECG preferably by standard 12, can dual-use concerning hospital, need not join special fetal electrocardiograph, to save the cost of hospital.
Present problem is: do not know how electrode that standard 12 is led electrocardiograph is placed detection record preferably at anemia of pregnant woman's body surface and, to Fetal ECG, needed a scheme.
List of references:
[1] Gao Zhen, occupy Guiping, Zuo Zhiming (Norman Bethune Medical University): singly lead the development of Fetal ECG monitor, health care equipment, the 1st phase of calendar year 2001.
[2] Huanan Medical Electrical Tech Co., Ltd., Henan, fetal electrocardiograph, in May, 2006, Chinese utility model patent: Z1200520111843.5
[3] Lu Yaosheng, Liang Yuhou: for the method and apparatus of monitoring contraction activities of mother womb and control labor, Chinese invention patent, application number: 03113712.1
[4] Wang Jiada, Liu Zuwang: the design of the Wireless Fetal Electrocardiogram Monitoring System based on S3C2410, Chinese Journal of Medical Instrumentation, the 7th phase of 31 volumes in 2007.
[5] Li Zhongjian etc.: the routine examining report of stomach wall fetal electrocardiogram 1633, Chinese doctor studies magazine volume the 2nd phase general news column February the 29th in 2006
summary of the invention
Goal of the invention.
Propose a kind of standard 12 and lead the placement schemes of electrocardiographicelectrodes electrodes at anemia of pregnant woman's body surface, can detect preferably and be recorded to Fetal ECG.
Technical scheme.
The laying method of electrode comprises steps such as placing front processing preparation and placement, the present invention proposes a kind of laying method of electrode while by standard 12, leading electrocardiograph detection Fetal ECG, it is characterized in that: a kind of laying method of leading electrocardiograph electrode while detecting Fetal ECG by standard 12, it is characterized in that: (1) test electrode all adopts SMD electrode, (2) anemia of pregnant woman's body surface electrode to be pasted place is clean by alcohol wipe, (3) electric conductivity of conducting resinl or conductive liquid is better than common adult with conducting resinl or conductive liquid, (4) to right upper extremity VR, left upper extremity VL in former 12 beacon standards, left lower limb VF tri-electrodes, allow it 1 adhere on pubic symphysis top stomach wall, it 1 adheres on top stomach wall at the bottom of palace, it 1 adheres on right side stomach wall or left side stomach wall, that is to say, as long as stomach wall, flank wall post respectively one of them electrode above at the bottom of stomach wall, palace above pubic symphysis, (5), to the right lower limb electrode RL in former 12 beacon standards, adhere on the position that facilitates of stomach wall, (6) to 6 breast conductive electrode C1 in former 12 beacon standards, C2, C3, C4, C5 and C6, adhere on respectively the regular hexagon summit of anemia of pregnant woman's abdominal wall surface, regular hexagon is centered by the mid point of 2 lines of top stomach wall electrode at the bottom of pubic symphysis top stomach wall electrode and palace, perhaps centered by the umbilicus loca, regular hexagon is about symmetrical up and down, the body surface line that refers to up and down neck item and pubic symphysis top, left and right refers to through central point and the upper and lower vertical body surface line of line therewith, and allow left and right line through central point through orthohexagonal two summits, the regular hexagon circumscribed circle diameter is got about 20cm.Above arrangement of electrodes scheme, for convenient, describe by the pregnant woman lays on her back position.Accompanying drawing 1 is shown in by arrangement of electrodes scheme schematic diagram.
Be not that the inventor arbitrarily proposes with the top electrode placement schemes, but lead electrocardiograph by standard 12, a large amount of clinical trials by 100 anemia of pregnant woman propose on the basis of having found certain law.These rules comprise: when SMD electrode is used in (1) 12 10 electrodes unifications leading electrocardiograph, polarizing voltage is little, and the signal to noise ratio of measured signal is high, more easily finds the fetal rhythm electricity; (2), before pasting electrode slice, treat that to paste position clean by alcohol wipe, and with conducting resinl or conductive liquid preferably, the signal to noise ratio of measured signal is high, more easily finds the fetal rhythm electricity; (3) it is generally acknowledged, the female fetal rhythm electricity of anemia of pregnant woman's body surface mixes, and the fetal rhythm electricity is too small, be difficult for seeing and being recorded to, but the inventor studies discovery, on some point of anemia of pregnant woman's stomach wall or direction, Fetal ECG is not little, even can be also large by parent electrocardio composition, this is a brand-new discovery; (4) although shrinking diastole, heart of fetus has individual variation, fetus position difference in the Potential distribution of parent body surface generation, but by electrode placement schemes of the present invention, because the voltage of multiple directions can measure, generally always have to lead to be recorded to the Fetal ECG of high s/n ratio; (5) although standard 12 is led the inside of electrocardiograph realizes having differently from special-purpose fetal electrocardiograph, this does not hinder electrode slice to be attached to after stomach wall the voltage that records multiple directions.Electrode placement schemes of the present invention is the embodiment to above knowledge of regularity.
Beneficial effect.
The inventor leads electrocardiograph in hospital by standard 12 100 anemia of pregnant woman's fetal rhythm electricity has been carried out to detection record.Front 3 anemia of pregnant woman's electrode is not placed and is undertaken by the scheme of application protection, although 6 breast conductive electrode are placed on stomach wall, 4 limb conductive electrode are all surveyed Electrocardiographic standard folder method (respectively electrode holder being clipped in to right upper extremity, left upper extremity, left lower limb, right lower limb) with the adult; In the case, recorded altogether 10 groups of data, all can't see " trace " of Fetal ECG composition, the electrocardiogram of the 1 group of data wherein 1 anemia of pregnant woman recorded as shown in Figure 2.In accompanying drawing 2,8 tunnel independence lead signals of electrocardiograph record, although seeing very clearly, be all maternal ecg, can't see the Fetal ECG composition.
To 97 anemia of pregnant woman of back, while by standard 12, leading electrocardiograph detection record fetal rhythm electricity, all adopt the electrode placement schemes of the present patent application protection to carry out.Every anemia of pregnant woman, in about 5 minutes, has surveyed 3 to 6 groups of data, and 97 anemia of pregnant woman have surveyed 454 groups of data altogether.To 3 to 6 groups of data of every anemia of pregnant woman, the electrode laying method has some to change in the scheme protection domain, the position that may move a bottom right lower limb electrode as the two adjacent groups data, or the 1 limb conductive electrode that the left side stomach wall is placed moves on to again stomach wall place, right side etc.Research is found, 414 groups of data in 454 groups of data that detect, at least exist some lead signals that sufficiently high fetal rhythm electricity signal to noise ratio (can find out tire cardiac electrical " trace " " symptom of a trend " in other words) is arranged, like this, in follow-up processing, just can go out fetal electrocardiogram clearly by separating-purifying; Wherein, some data to record, some fetal rhythm electricity led is also more obvious than parent electrocardio, sees V1 and V3 lead signals (noticing during observation that fetus interval aroused in interest is less than parent interval aroused in interest) in accompanying drawing 5, and the concrete placement of accompanying drawing 5 test electrodes is shown in shown in accompanying drawing 3 and accompanying drawing 4.Find in addition, the fine setting of electrode placement location in scheme, detect the cardiac electrical general effect of tire equally matched.If add up the success rate of electrode placement schemes of the present invention by the anemia of pregnant woman, every anemia of pregnant woman of 97 anemia of pregnant woman has high-quality fetal rhythm electrographic recording to arrive, success rate 100%, and the effect of this and the accurate laying method of existing 12 beacon has formed stark contrast.
Lead electrocardiograph by standard 12 and remove test record fetal rhythm electricity by this electrode placement schemes, a tractor serves several purposes, can save the cost of hospital.
the accompanying drawing explanation
Fig. 1, electrode placement schemes schematic diagram of the present invention when standard 12 is led electrocardiograph detection fetal rhythm electricity.
Fig. 2, the fetal rhythm electro-detection when placement of 4 limb conductive electrode is put method with adult in primary standard is example as a result.
Fig. 3, the concrete layout schematic diagram of test electrode in embodiment.
Fig. 4, the concrete layout realistic picture of test electrode in embodiment.
Fig. 5, in embodiment according to a fetal rhythm electricity result of this programme electrodes detection record.
The specific embodiment (embodiment)
Before in October, 2011, Nanjing University tests 100 anemia of pregnant woman's fetal rhythm electricity altogether at Nanjing Military Command's hospital general's department of obstetrics and gynecology: (1) is 37 pregnant Zhou Yihou; (2) every anemia of pregnant woman only tests 1 time; (3) divide 2-3 kind arrangement of electrodes situation (fine setting in the present invention program) to survey altogether 3-6 group data at every turn; (4) every group of data are 24 seconds length, the mfer form; (5) electrocardiograph used is that Japanese photoelectricity standard 12 is led electrocardiograph---ECG-1350P.
Be below by concrete electrode of the present invention, to place in a certain Data Detection: (1) test electrode all adopts the supporting SMD electrode of daily output of Japanese ECG-1350P electrocardiograph; (2) anemia of pregnant woman's body surface electrode to be pasted place is clean by 75% alcohol wipe; (3) after the SMD electrode of the daily output of supporting electrocardiograph removes protecting film, the superior conducting resinl of one deck is arranged, need not re-use other conducting resinl or conductive liquid; (4) right upper extremity VR, the left upper extremity VL in former 12 beacon standards, left lower limb VF tri-electrodes, adhere on respectively top stomach wall at the bottom of pubic symphysis top stomach wall, palace, right side stomach wall; (5), to the right lower limb electrode RL in former 12 beacon standards, adhere near the umbilicus place; (6) to 6 breast conductive electrode C1, C2, C3, C4, C5 and C6 in former 12 beacon standards, adhere on respectively the regular hexagon summit of anemia of pregnant woman's abdominal wall surface, here, regular hexagon is about umbilicus loca centrosymmetry, simultaneously, orthohexagonal upper and lower symmetrical horizontal line is through horizontal two farthest vertices, and the regular hexagon circumscribed circle diameter is got about 20cm.The concrete layout of electrode seen shown in accompanying drawing 3 and accompanying drawing 4.
Standard 12 is led electrocardiograph---and the waveform of 8 independent lead signals of these data of ECG-1350P record is shown in shown in accompanying drawing 5.From accompanying drawing 5, can see, leads I signal, leads I I signal, the V1 signal that leads, the V3 signal that leads all clearly have been recorded to fetal electrocardiogram in high quality, and the V1 signal that especially leads, the V3 Signal-to-Noise that leads are very high---and the composition of fetus is also larger than precursor composition.
Claims (1)
1. a laying method of leading electrocardiograph electrode while detecting Fetal ECG by standard 12, it is characterized in that: (1) test electrode all adopts SMD electrode, (2) anemia of pregnant woman's body surface electrode to be pasted place is clean by alcohol wipe, (3) electric conductivity of conducting resinl or conductive liquid is better than common adult with conducting resinl or conductive liquid, (4) to right upper extremity VR, left upper extremity VL in former 12 beacon standards, left lower limb VF tri-electrodes, allow it 1 adhere on pubic symphysis top stomach wall, it 1 adheres on top stomach wall at the bottom of palace, it 1 adheres on right side stomach wall or left side stomach wall, that is to say, as long as stomach wall, flank wall post respectively one of them electrode above at the bottom of stomach wall, palace above pubic symphysis, (5), to the right lower limb electrode RL in former 12 beacon standards, adhere on the position that facilitates of stomach wall, (6) to 6 breast conductive electrode C1 in former 12 beacon standards, C2, C3, C4, C5 and C6, adhere on respectively the regular hexagon summit of anemia of pregnant woman's abdominal wall surface, regular hexagon is centered by the mid point of 2 lines of top stomach wall electrode at the bottom of pubic symphysis top stomach wall electrode and palace, perhaps centered by the umbilicus loca, regular hexagon is about symmetrical up and down, the body surface line that refers to up and down neck item and pubic symphysis top, left and right refers to through central point and the upper and lower vertical body surface line of line therewith, and allow left and right line through central point through orthohexagonal two summits, the regular hexagon circumscribed circle diameter is got about 20cm.
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Families Citing this family (8)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102973265A (en) * | 2012-12-07 | 2013-03-20 | 河南华南医电科技有限公司 | Fetal electrocardiogram orthorhombic lead system |
| CN103767701A (en) * | 2014-01-10 | 2014-05-07 | 中南民族大学 | Wearable fetal electrocardiogram monitoring system and method based on smart phones |
| CN104382585B (en) * | 2014-11-25 | 2016-06-22 | 蒋淑清 | Detect with oneself the Apparatus and system of anemia of pregnant woman's vital sign |
| CN107411736A (en) * | 2017-03-10 | 2017-12-01 | 孙彪 | Fetal ECG signal detection system |
| CN110090013B (en) * | 2019-04-30 | 2023-11-14 | 潍坊医学院 | Electrocardiosignal acquisition method and acquisition circuit based on navel reference electrode |
| CN110464336B (en) * | 2019-08-08 | 2024-05-07 | 重庆市中医院 | Novel electrocardiograph leads and connects structure |
| CN110507362B (en) * | 2019-09-09 | 2023-06-23 | 邹金沙 | Production axis construction method, fetal head position measurement method and device |
| CN110604564B (en) * | 2019-09-16 | 2023-01-17 | 深圳市理邦精密仪器股份有限公司 | Electrode system, fetal electrocardiosignal acquisition and measurement method and device |
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Effective date of registration: 20210104 Address after: 811-3, 8th floor, building 4, 209 Zhuyuan Road, Suzhou high tech Zone, Jiangsu Province, 215011 Patentee after: Suzhou greede medical sensor technology Co.,Ltd. Address before: Box 1040, School of electronics, Nanjing University, 22 Hankou Road, Gulou District, Nanjing, Jiangsu 210093 Patentee before: NANJING University |