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研究生:楊仲軒
研究生(外文):Chung-Hsuan Yang
論文名稱:不同組織間定位輔助裝置之研製—以硬脊膜外腔定位為例
論文名稱(外文):Device for the identification of different tissue types –on the example of identifying epidural space
指導教授:趙福杉
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:醫學工程學研究所
學門:工程學門
學類:綜合工程學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:33
中文關鍵詞:硬脊膜外腔麻醉阻力消失法壓阻式力量感測器
外文關鍵詞:epidural anesthesialoss of resistance techniquepiezo-resistive force sensor
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  硬脊膜外腔麻醉手術是一種常見的麻醉手術,而該麻醉手術最常出現的意外是不小心穿破硬脊膜。為了避免這類意外,正確定位硬脊膜外腔是手術成敗的關鍵。傳統的阻力消失法是最常見的硬脊膜外腔定位技術,但實際執行時卻需要麻醉醫師良好的觸覺感知能力及經驗。近年來有許多新技術被提出來,這些技術提供了額外的視覺或聽覺的輔助訊號以精確鑑定硬脊膜外腔之位置,然而與傳統的方式相比較之後,卻因為太過於複雜而沒有被廣泛接受。
  本研究設計了一個新穎的硬脊膜外腔之定位裝置,藉由在一般硬脊膜外腔定位針筒的末端裝上一個壓阻式力量感測器,可以同時產生聲音和視覺的輔助訊號。本裝置具有體積小、成本低的優點,且使用上與傳統阻力消失法方式一致,較容易為麻醉科醫師所接受。此外,由於力量感測器位於針筒外部,與其他將感測器裝於針筒內部的方法比較起來更可降低與患者體液直接接觸而造成感染的風險。
Epidural anesthesia is a widely accepted procedure. Since accidental dural puncture is the common accident, identifying epidural space during the procedure is the most important thing. Traditional technique, namely loss of resistance, is commonly used to detect the epidural space. However, this technique requires well tactile perception of an experienced anesthetist. Several devices were proposed to improve the technique by supplying additional visual or acoustic signals while the epidural space is arrived. Yet these devices are seldom used due to their complexity.
By using a piezo-resistive force sensor placed at the bottom of the epidural syringe, a novel auxiliary device that can generate visual as well as acoustic signals was proposed. The device is small, low cost and mimic to the traditional loss of resistance technique. Furthermore, the force sensor will not direct contact with the subjects and hence greatly reduce the risk of infection.
誌謝 i
目錄 ii
圖目錄 iv
表目錄 v
中文摘要 vi
英文摘要 vii

第一章序論
  1.1 研究背景與動機 1
  1.2 硬脊膜外腔解剖與生理 2
  1.3 硬脊膜外腔定位技術 2
  1.4 系統設計之目標 4
第二章 研究方法與系統設計
  2.1 系統架構 6
  2.2 力量感測器 7
  2.3 信號調控單元 10
    2.3.1 電導電壓換能器 11
    2.3.2 濾波器 12
    2.3.3 電壓-頻率轉換器 13
  2.4 資料擷取單元 14
  2.5 使用者介面 15
  2.6 輸入輸出特性量測方法 17
第三章 研究結果
  3.1 裝置外觀 18
  3.2 輸入輸出特性量測 19
  3.3 硬脊膜外腔定位模擬測試 20
第四章 討論
  4.1 總結 27
  4.1硬脊膜外腔輔助定位裝置特性討論 27
  4.2與其他硬脊膜外腔定位方式之比較 28

參考文獻 30
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