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77BP B3 AFIB
AR
1 . ϲϓ ϻ· ρηϧϳ ϻ) έϛΑϣϟ΍ ϑΎηΗϛϻ΍ ϝΟ΃ ϥϣ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ έη΅ϣ έϭϬυ
(MAM ϊοϭ
ϡΗ Ϫϧ΃ ϰϟ· BK ίϣέϟ΍ ΍Ϋϫ έϳηϳ .(AF) ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ϑηϛ ίΎϬΟϟ΍ ΍Ϋϫ ϊϳρΗγϳ
ϝϭλΣϠϟ ΔϳϟΎΗϟ΍ ΓέϘϔϟ΍ ϰϟ· ωϭΟέϟ΍ ˯ΎΟέϟ΍ .αΎϳϘϟ΍ ˯ΎϧΛ΃ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ϑΎηΗϛ΍
.ϙΑϳΑρ ϊϣ έϭΎηΗϟΎΑ ΔϘϠόΗϣϟ΍ ΕΎϣϭϠόϣϟ΍ ϰϠϋ
ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ έη΅ϣϟ έέϛΗϣϟ΍ έϭϬυϟ΍ ϝϭΣ ΏϳΑρϟ΍ ιΧΗ ΕΎϣϭϠόϣ
ϡΎυΗϧ΍ ϡΩϋ Ύ
˱
οϳ΃ ϝϠΣϳϭ ΕΎΑΫΑΫϟΎΑ ϡΩϟ΍ ρϐο αΎϳϘϟ Γ΍Ω΃ ϥϋ ΓέΎΑϋ ίΎϬΟϟ΍ ΍Ϋϫ
.ΔϳϛϳϧϳϠϛ· Ε΍έΎΑΗΧϻ ίΎϬΟϟ΍ ΍Ϋϫ ϊοΧϳ .αΎϳϘϟ΍ ϝϼΧ νΑϧϟ΍
.αΎϳϘϟ΍ ϝϼΧ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ωϭϗϭ ΔϟΎΣ ϲϓ αΎϳϘϟ΍ ΩόΑ AFIB ίϣέ έϬυϳ
ΕΎγΎϳϗ) ϝϣΎϛϟΎΑ ϡΩϟ΍ ρϐο αΎϳϗ ΓέϭΩ ΫϳϔϧΗ ΩόΑ AFIB ίϣέ
έϭϬυ ΔϟΎΣ ϲϓ
έϬυ ΍Ϋ· .(ΔϳΛϼΛ ΕΎγΎϳϗ) ϯέΧ΃ Γέϣ αΎϳϘϟ΍ ˯΍έΟΈΑ νϳέϣϟ΍ ΢λϧ
˵
ϳ ˬ(ΔϳΛϼΛ
ίϣέ έϬυ ΍ΫΈϓ .ΔϳΑρϟ΍ ΔΣϳλϧϟ΍ ΏϠρΑ ΏϳΑρϟ΍ ΢λϧϧ ΎϧϧΈϓ ˬ΍
˱
ΩΩΟϣ AFIB ίϣέ
ΔΑΎλϹ΍ ΔϳϟΎϣΗΣ΍ ϰϟ· έϳη
˵
ϳ ϙϟΫϓ ˬϡΩϟ΍ ρϐο αΎϳϗ ίΎϬΟ ΔηΎη ϰϠϋ AFIB
ϲϧϳΫϷ΍ ϥΎϔΟέϟΎΑ ΔΑΎλϹΎΑ ιϳΧηΗϟ΍ Ωϭόϳ ϥ΃ ΏΟϳ ϥϛϟϭ .ϲϧϳΫϷ΍ ϥΎϔΟέϟΎΑ
.ΏϠϘϟ΍ ρϳρΧΗ ίΎϬΟ Γ˯΍έϗ ϰϠϋ
˱
˯ΎϧΑ
ΏϠϘϟ΍ ΏϳΑρϟ
(.ϑηΗϛϳ ϻ Ωϗ .Δ΋ρΎΧϟ΍ Ε΍˯΍έϘϟ΍ ΏϧΟΗϟ αΎϳϘϟ΍ ϝϼΧ ω΍έΫϟ΍ ΕΎΑΛ ϰϠϋ υϓΎΣ
( ιΎΧηϻ΍ ϯΩϟ ˬϲϧϳΫϷ΍ ϥΎϔΟέϟΎΑ ΔΑΎλϹ΍ϪϓΎηΗϛ΍ ΊρΧ
˵
ϳϥϛϣϣίΎϬΟϟ΍ ΍Ϋϫ
.ΏϠϘϟ΍ ΕΎΑέο ϡϳυϧΗ ΓίϬΟ΃ ϭ΃ ΔϣυΎϧ ΓίϬΟ΃ ϥϭόοϳ ϥϳΫϟ΍
( ϲρΎγΑϧϻ΍ ϡΩϟ΍ ρϐο Δϣϳϗ ϥϭϛΗ ϻ Ωϗ ˬϲϧϳΫϷ΍ ϥΎϔΟέϟΎΑ ΔΑΎλ·
ΩϭΟϭ Ωϧϋ
.ΔϘϳϗΩέϳϏ
( ϝϭλΣϠϟ MAM ϊοϭ ϡ΍ΩΧΗγΎΑ ϰλϭ
˵
ϳ ϲϧϳΫϷ΍ ϥΎϔΟέϟΎΑ ΔΑΎλ· ΩϭΟϭ ϲϓ
.ϡΩϟ΍ ρϐοϟ ΔϗΩ έΛϛ΃ αΎϳϗ ϰϠϋ
ˮ(AF) ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ϭϫ Ύϣ
ΎϳϼΧ .ΔϣυΗϧϣ ΏϠϗ ΕΎΑέο ϰϠϋ ϝϭλΣϠϟ ϲόϳΑρ ϝϛηΑ ργΑϧϳϭ ϙΑϠϗ νΑϘϧϳ
ΙΩΣϳ .ϡΩϟ΍ Φοϭ ΏϠϘϟ΍ νΎΑϘϧ΍ ΏΑγΗ Δϳ΋ΎΑέϬϛ Ε΍έΎη· ΞΗϧΗ ϙΑϠϗ ϲϓ Δϧϳόϣ
ϥϳϣγϘϟ΍ ϲϓ ΔϣυΗϧϣ έϳϏϭ Δόϳέγ
ΔϳΑέϬϛ Ε΍έΎη· ΩϭΟϭ Ωϧϋ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍
ΓέϭλΑ ΎϣϬοΎΑϘϧ΍ ϲϓ ΏΑγΗϳ Ύϣϣ ϥϳΫϷ΍ ϡγΎΑ ϥϳϓέόϣϟ΍ϭ ΏϠϘϟ΍ ϥϣ ϥϳϳϭϠόϟ΍
Δό΋Ύηϟ΍ ρΎϣϧϷ΍ έΛϛ΃ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ Ωόϳ .(ϥΎϔΟέϟΎΑ ϙϟΫ ϑέόϳ) ΔϣυΗϧϣ έϳϏ
ϝ΋Ύϫ ϝϛηΑ Ωϳίϳ Ϫϧϛϟϭ ν΍έϋ΃ ϱ΃ έϭϬυ ΏΑγϳ ϻ Ϫϧ΃ Ύϣϛ .ΏϠϘϟ΍ Ώ΍έροϻ
ϩΫϫ ϰϠϋ ΏϠϐΗϟ΍ ϲϓ ϙΩϋΎγϳϟ ΏϳΑρ ϰϟ· ΝΎΗΣΗγ .ΔϳΑϠϗ
ΔΑϭϧϟ ϙοέόΗ έρΧ ϥϣ
.ΔϠϛηϣϟ΍
ˮϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ιΣϔϟ ϊοΧϳ ϥ΃ ϪϳϠϋ ϱΫϟ΍ ϥϣ
ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ιΣϓ ˯΍έΟΈΑ Ύ
˱
ϣΎϋ 65 ϡϫέϣϋ ώϠΑϳ ϥϳΫϟ΍ ιΎΧηϷ΍ ϰλϭϳ
ϰλϭϳ Ύϣϛ .έϣόϟ΍ ϲϓ ϡϬϣΩϘΗ ϊϣ ΔϳϏΎϣΩϟ΍ ΔΗϛγϟΎΑ ΔΑΎλϺϟ Δοέϋ έΛϛϷ΍ ϡϬϧϭϛ
ρϐο :ϝΛϣ) ϡΩϟ΍ ρϐο ωΎϔΗέ΍ ϥϣ ϥϭϧΎόϳ ϥϣϣ ϥϳγϣΧϟ΍ έϣϋ ϲϓ ιΎΧηϷ΍
ˬϪγϔϧ ιΣϔϟ΍ ˯΍έΟΈΑ (99
ϥϣ ϰϠϋ΃ϲρΎγΑϧϻ΍ϭ΃ 159 ϥϣ ϰϠϋ΃ ϲοΎΑϘϧϻ΍ ϡΩϟ΍
ΔΗϛγΑ ΍ϭΑϳλ΃ ϥϣϣ ϭ΃ ϲΟΎΗϟ΍ ϥΎϳέηϟ΍ έϭλϗ ϭ΃ ϱέϛγϟ΍ ˯΍ΩΑ ϥϳΑΎλϣϠϟ ΔϓΎοϹΎΑ
.ϝΑϗ ϥϣ ΔϳϏΎϣΩ
Kearley K, Selwood M, Van den Bruel A, Thompson M, Mant D,
1
Hobbs FR et al.: 7ULDJHWHVWVIRULGHQWLI\LQJDWULDO¿EULOODWLRQLQSULPDU\
care: a diagnostic accuracy study comparing single-lead ECG and
.e004565:4 ;2014 PRGL¿HG%3PRQLWRUVBMJ Open
Wiesel J, Arbesfeld B, Schechter D: Comparison of the Microlife
2
blood pressure monitor with the Omron blood pressure monitor for
.1048-114:1046 ;2014 GHWHFWLQJDWULDO¿EULOODWLRQAm J Cardiol
ΕΎϳϭΗΣϣϟ΍ϝϭΩΟ
1 . ϊοϭ ϲϓ ϻ· ρηϧϳ ϻ) έϛΑϣϟ΍ ϑΎηΗϛϻ΍ ϝΟ΃ ϥϣ ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ έη΅ϣ έϭϬυ
(MAM
ˮ(AF) ϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ϭϫ Ύϣ
ˮϲϧϳΫϷ΍ ϥΎϔΟέϟ΍ ιΣϔϟ ϊοΧϳ ϥ΃ ϪϳϠϋ ϲϐΑϧϳ ϱΫϟ΍ ϥϣ
ΎϬϳϠϋ Γέρϳγϟ΍ ϙϧϛϣϳ ϲΗϟ΍ έρΧϟ΍ ϝϣ΍ϭϋ
2 .ϰϟϭϷ΍ ΓέϣϠϟ ίΎϬΟϟ΍ ϡ΍ΩΧΗγ΍
ΕΎϳέΎρΑϟ΍ ΏϳϛέΗ
Εϗϭϟ΍ϭ ΦϳέΎΗϟ΍ ρΑο
΢ϳΣλϟ΍ ω΍έΫϟ΍ ϡ΍ίΣ έΎϳΗΧ΍
.MAM
ϊοϭ ϭ΃ ϲγΎϳϘϟ΍ ϊοϭϟ΍ έΎϳΗΧ΍
3 ..ΔϘΛϟΎΑ έϳΩΟ αΎϳϗ ϰϠϋ ϝϭλΣϠϟ ΔϳόΟέϣ Δϣ΋Ύϗ
4 ..ϡΩϟ΍ ρϐο αΎϳϘΑ ΃ΩΑ΍
ϱϭΩϳϟ΍ Φϔϧϟ΍
Γ˯΍έϗ ϥϳίΧΗ ΏϧΟΗ Δϳϔϳϛ
ˮϲϣΩ ρϐο ϡ
˷
ϳϗ΃ ϑϳϛ
.(PAD) ΏϠϘϟ΍ ΕΎοΑϧ ϡΎυΗϧ΍ ϡΩϋ έϭϬυ
5 .ΕΎϧΎϳΑϟ΍ Γέϛ΍Ϋ
ΔϧίΧϣϟ΍ ϡϳϘϟ΍ νέϋ
ϡϳϘϟ΍ ϝϛ ΢γϣ
6 .ΔϳέΎρΑϟ΍ έϳϳϐΗϭ ΔϳέΎρΑϟ΍ έη΅ϣ
ΔϳέΎρΑϟ΍ ϥΣη
νΎϔΧϧ΍
ϝ΍ΩΑΗγ΍ - ΓΩϣΎϫ ΔϳέΎρΑ
ˮΕ΍˯΍έΟϹ΍ Ύϣϭ ΕΎϳέΎρΑϟ΍ Ύϣ
ϥΣηϟ΍ ΓΩΎϋϹ ΔϠΑΎϗ ΕΎϳέΎρΑ ϡ΍ΩΧΗγ΍
7 .ϲγϳ΋έϟ΍ έΎϳΗϟ΍ έΩλϣ ϝϭΣϣ ϡ΍ΩΧΗγ΍
8 .΄ρΧϟ΍ ϝ΋Ύγέ
9 .ίΎϬΟϟ΍ ϥϣ ιϠΧΗϟ΍ϭ ΔϗΩϟ΍ϭ ΔϳΎϧόϟ΍ϭ ϥΎϣϷ΍ έΎΑΗΧ΍
ΔϳΎϣΣϟ΍ϭ ϥΎϣϷ΍
ίΎϬΟϟΎΑ ΔϳΎϧόϟ΍
ω΍έΫϟ΍ ϡ΍ίΣ ϑϳυϧΗ
ΔϗΩϟ΍ έΎΑΗΧ΍
ίΎϬΟϟ΍ ϥϣ ιϠΧΗϟ΍
10 .ϥΎϣοϟ΍
11 .Δϳϧϔϟ΍ΕΎϔλ΍ϭϣϟ΍
ϲϔϠΧϟ΍ϑϼϐϟ΍έυϧ΍ϥΎϣοΔϗΎρΑ
79


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