臺灣博碩士論文加值系統

本研究在成功大學體外震波碎石機實驗室中分別完成了，在不同放電介質特性下的體外震波碎石機之模擬結石分解實驗與模擬組織的傷害實驗。研究結果顯示真空除氣水比清水作為放電介質，可產生比較大之聚焦點上最大壓力以及比較大之放電時之接地電流量，也因而具有較佳的結石分解特性，此結果可分別由發泡煉石與肺石等二種模擬結石之分解過程圖片中予以驗證，然而伴隨巨大聚焦壓力後的強大張力波即是造成空蝕誘導組織傷害的元兇，本實驗觀察中發現清水造成密集式的傷害，真空除氣水則造成比較分散式的傷害，在減少組織傷害並維持結石分解能力的目標下，於實驗中發現，於真空除氣水與清水中分別加入適量的清潔劑時，於放電後的聚焦點上前者可產生比較高的最大聚焦壓力與最少的負壓值，此結果顯示，真空除氣水與清潔劑的組合作為放電介質可能達到分解結石且減少組織傷害的目的。

An investigation on stone disintegration and tissue damage by an Extracorporal Shock Wave Lithotriptor (ESWL) under different characteristics of current-discharging medium has been conducted in the ESWL Laboratory in National Cheng Kung University. The experimental results indicate that for degassed water the maximum pressure measured at the focal point are much higher than that for tap water. This is due to high grounding current in degassed water. Such a higher pressure on the focal point has a direct contribution to stone disintegration. The sample stones used are leca stones and pneumolith stones. However, to relieve tissue damage caused by cavitation generated by a negative pressure following the positive pulse of a shock, it is necessary to reduce the negative pressure, but retaining a high enough positive pressure. It has been observed that with adding a proper amount of liquid detergent in degassed water, the ratio of the maximum positive pressure to the maximum negative pressure is higher than that without detergent. It is concluded that the degassed water with detergent is a good candidate as a current-discharging medium for an ESWL, since the suggested medium can produce good characteristics of stone disintegration and of reducing tissue damage.

中文摘要 i
英文摘要 ii
誌謝 iii
目錄 iv
表目錄 vi
圖目錄 vi
符號說明 viii
第一章 緒論 1
1-1研究動機與目的 1
1-2文獻回顧 1
第二章 理論分析 4
2-1體外震波基本原理 4
2-1.1 球震波之基本特性 4
2-1.2震波反射之基本型態 5
2-1.3爆震波聚焦的基本特性 6
2-1.4體外震波碎石機之應用原理 7
2-2 空蝕現象在體外震波碎石的角色 8
2-3 體外震波碎石機之結石分解與組織傷害原理 9
2-3.1 簡介震波碎石機制 9
2-3.2 組織傷害成因 10
2-3.3 壓力與張力破壞模式 11
2-3.4裂縫的成長-聚合區理論 12
2-3.5 結石分裂的推手-剝離模式 13
2-3.6 動態疲勞破壞 14
2-3.7組織傷害減低的條件 18
第三章 實驗設備、方法及步驟 21
3-1實驗設備 21
3-1.1體外震波碎石機設備 21
3-1.2壓力量測系統 22
3-1.3資料擷取系統 23
3-1.4真空除氣系統與水含氧量感測器 23
3-1.5震波傳遞介質之導電度計 24
3-1.6凝膠體測試平台 24
3-2實驗方法 24
3-3實驗步驟 25
第四章 結果與討論 30
4-1 聚焦點處震波性能 30
4-2 接地電流比較 31
4-3 結石粉碎結果 31
4-4 凝膠假體模擬分析 32
4-5 張力波的改善 33
第五章 結論與建議 35
5-1 結論 35
5-2 建議 36
參考文獻 37
自述 80
著作權聲明 81

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