跳到主要內容

臺灣博碩士論文加值系統

(3.231.230.177) 您好!臺灣時間:2021/07/28 19:36
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:賴昱斌
研究生(外文):Yu-BinLai
論文名稱:阻塞性睡眠呼吸中止症之口腔裝置研發
論文名稱(外文):Development of Oral Appliance for Obstructive Sleep Apnea
指導教授:李輝煌李輝煌引用關係
指導教授(外文):Huei-Huang Lee
學位類別:碩士
校院名稱:國立成功大學
系所名稱:工程科學系碩博士班
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:2012
畢業學年度:100
語文別:中文
論文頁數:53
中文關鍵詞:打鼾睡眠呼吸中止症有限元素分析持續性正壓呼吸器口腔治療裝置呼吸暫停低通氣指數
外文關鍵詞:SnoringObstructive Sleep ApneaFinite Element AnalysisContinuous Positive Air PressureOral appliance
相關次數:
  • 被引用被引用:0
  • 點閱點閱:221
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
隨著醫療技術的發展,打鼾逐漸被人們重視。打鼾常常被人們誤認為是身體太疲累而造成的生理現象,但打鼾其實是睡眠呼吸中止症症狀之一。睡眠呼吸中止症對人們造成的影響有白天嗜睡、精神不集中、高血壓、心血管疾病甚至發生交通事故,這些看起來不是很明顯,但有時後卻是致命的。
睡眠呼吸中止症的治療方式有利用持續性正壓呼吸器、口腔裝置以及手術治療,而本論文著重在口腔裝置上。口腔裝置現在市面上的產品有超過20種,而大部分在設計上不符合人體工學,所以大部分產品使用起來常常使人們感到不適。
本論文為了改良市面上產品讓使用者感到更符合人體工學並改善呼吸中止症,進而設計一種高靈活度的口腔裝置,本論文設計的裝置主要是利用將下巴往前移動再藉著摩擦力的效果使下巴不會往回收,希望藉此來達到降低打鼾強度及呼吸暫停低通氣指數 (Apnea-hypopnea Index, AHI) 並利用有限元素軟體去分析設計的口腔治療裝置機構上的摩擦力作用是否足夠防止在睡覺時下巴往回收。
從結果可以確定摩擦力的作用是足夠阻止下巴往回收,但是不適用在有磨牙症症狀的病患。

With the development of medical technology, snoring gradually has been attended in recent years. Snoring is usually mistaken for the physiological phenomenon because the body is too tired. Actually, snoring is one of symptoms in obstructive sleep apnea. The obstructive sleep apnea will result in persisting sleepiness in daytime, a lack of concentration, hypertensive crisis, cardiovascular disease and even traffic accidents. These symptoms seem to be unimportant in daily time, but sometimes that are fatal in life.
Present treatments for obstructive sleep apnea include continuous positive air pressure, oral appliances and performing surgery. This thesis focuses on oral appliances. There are more than 20 kinds of oral appliances on the market, but most of them are often not flexible enough to be adjusted to fit these devices to all possible cases. These oral appliances are not ergonomically designed, so patients often feel uncomfortable in using existing produtions.
In order to make users feel more comfortable and improve obstructive sleep apnea effectively, a highly flexible oral appliance has been presented in the study. The oral device uses friction effect to maintain mandibular forward, and ensures that mandibular would not slide back during sleeping. As a result, the conceptual design is developed for reducing intensity of snoring and apnea-hypopnea index. For verifying the appliance is strong enough to prevent mandibular from sliding back, the study uses commonly commercial finite element software ANSYS for analysis.
The results show that friction effect could certainly prevent mandibular from sliding back, but that is not sustainable for those patients with bruxism symptoms. However, patients with bruxism symptoms is adapted for neither oral appliance proposed by this thesis nor others on the market.

摘要 I
ABSTRACT II
表目錄 VII
圖目錄 VIII
第一章 緒論 1
1-1前言 1
1-2動機 1
1-3論文架構 2
第二章 研究背景及文獻回顧 4
2-1研究背景 4
2-1-1睡眠週期 4
2-1-2上呼吸道之解剖學 5
2-1-3睡眠呼吸中止症 6
2-1-4 OSA的評估 8
2-1-5 OSA的治療方法 10
2-2文獻回顧 14
第三章 口腔裝置及專利探討 17
3-1口腔裝置 17
3-2專利回顧 18
第四章 口腔裝置設計及有限元素分析 27
4-1口腔裝置設計 27
4-2有限元素分析 32
4-2-1材料設定 32
4-2-2幾何模型 33
4-3邊界條件及分析設定 35
4-4模擬結果 40
第五章 結論與未來展望 43
5-1結論 43
5-2未來展望 44
參考文獻 46
索引 51

[1]Roffwarg et al., “Ontogenetic development of the human sleep-dream cycle, Science, Vol 152, 604-619, 1966.
[2]Des Jardins, Terry R., Cardiopulmonary Anatomy & Physiology: Essentials for Respiratory Care, 4th ed., Albany Delmar Thomson Learning, Australia, 2002.
[3]李佩玲醫師,“睡眠呼吸障礙,"台大醫院睡眠中心。
[4]陳濘宏,“呼吸中止症可從打鼾聲判別?,"商業週刊,第1280期,98-100頁,2012年6月。
[5]Fujita S., “Midline laser glossectomy with linguoplasty: a treatment of sleep apnea syndrome, Operative Techniques Otolaryngol Head Neck Surg, 2, pp.127-131, 1991.
[6]蕭光明,“睡眠呼吸中止症外科療法可以完全根治嗎?,健康世界,新版314期,56-61頁,2012年2月。
[7]Winfried J. Randerath, Markus Heise, Rolf Hinz and Karl-Heinz Ruehle, “An Individually Adjustable Oral Appliance vs Continuous Positive Airway Pressure in Mild-to-Moderate Obstructive Sleep Apnea Syndrome, CHEST, pp. 569-575, 2002.
[8]Atul Mehta, Jin Qian, Peter Petocz, M. Ali Darendeliler and Peter A. Cistulli, A Randomized, Controlled Study of a Mandibular Advancement Splint for Obstructive Sleep Apnea, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, vol. 163, 2001.
[9]A. J. Campbell, G. Reynolds, H. Trengrove and A. M. Neill, Mandibular advancement splint titration in obstructive sleep apnoea, Sleep Breath, vol. 13, pp. 157-162, 2009.
[10]Alister Neill, Robin Whyman, Scott Bannan, Oliver Jeffrey and Angela Campbell, Mandibular advancement splint improves indices of obstructive sleep apnoea and snoring but side effects are common, Journal of the New Zealand Medical Association, vol. 115, no. 1156, 21 June 2002.
[11]A.D. McGown, H.K. Makker, J.M. Battagel, P.R. LEstrange, H.R. Grant and S.G. Spiro, Long-term use of mandibular advancement splints for snoring and obstructive sleep apnoea: a questionnaire survey, Eur Respir J, vol. 17, pp. 462-466, 2001.
[12]Ghizlane Aarab, Frank Lobbezoo, Hans L. Hamburger and Machiel Naeije, Effects of an oral appliance with different mandibular protrusion positions at a constant vertical dimension on obstructive sleep apnea, Clin Oral Invest, no. 14, pp. 339-345, 2010.
[13]Marie-Louise Walker-Engström, Ivar Ringqvist, Olle Vestling, Bo Wilhelmsson, and Åke Tegelberg, A Prospective Randomized Study Comparing Two Different Degrees of Mandibular Advancement with a Dental Appliance in Treatment of Severe Obstructive Sleep Apnea, vol. 7, no. 3, 2003.
[14]Maree Barnes, R. Douglas McEvoy, Siobhan Banks, Natalie Tarquinio, Christopher G. Murray, Norman Vowles and Robert J. Pierce, Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, vol. 170, 2004.
[15]Bondemark L, Lindman R. “Craniomandibular status and function in patients with habitual snoring and obstructive sleep apnea after nocturnal treatment with a mandibular advancement splint: a 2-year follow-up, Eur J Orthod no. 22, pp.53–60, 2000.
[16]S. Y. Y. Woo, Articulating connector for mandibular repositioning oral appliance. U.S. Patent 6,012,920, 22 Apr. 1999.
[17]R. S. Callender, Apparatus for treatment of sleep apnea. U.S. Patent US 2009/0032030 A1, 18 Jan. 2008.
[18]B. D. Fuselier, Intra-oral apnea and snoring preventiong appliance. U.S. Patent US 2010/0154802 A1, 24 Dec. 2008.
[19]D. C. B. Richard A. Bonato, Adjustable dental apparatus for reducing snoring and improving sleep disordered breathing. U.S. Patent U.S Patent No. US 2008/0060659 A1, 13 Sep. 2006.
[20]T. E. Meade, Apparatus and method for the reduction of snoring. U.S. Patent 5,467,783, 6 Dec. 1994.
[21]G. L. L. B. R. D. P. C. S. R. B. K. Eugene N. Scarberry, Oral appliance for treatment of snoring and sleep apnea. U.S. Patent US 2007/0292819 A1, 11 May 2007.
[22]A. Heine, Mandibular advancement mouthpiece, an intraoccusal removable improved device for eliminating or reducing snoring. U.S. Patent 2008/0115791 A1, 15 Nov. 2007.
[23]G. Magnin, Mandibular advancement splint. U.S. Patent US 7,810,503 B2, 11 Jul. 2008.
[24]M. D. F. Don E. Frantz, Elastic mandibular advancement appliance with slide-in bite planes. U.S. Patent U.S Patent No. 5,947,724, 5 May 1997.
[25]M. D. F. Don E. Frantz, Elastic mandibular advancement appliance. U.S. Patent 6,109,265, 29 Oct. 1997.
[26]T. E. Meade, Mandibular advancement appliance. U.S. Patent US 2010/0307511 A1, 9 Dec. 2010.
[27]L. W. Halstrom, Adjustable dental appliance for treatment of snoring and obstructive sleep apnea. U.S. Patent 5,365,945, 13 Apr. 1993.
[28]E. Sarkisian, Apparatus and method for caring for obstructive sleep disorder breathing. U.S. Patent 2006/0174897 A1, 10 Aug.2006.
[29]D. F. Fenton, Anti-snoring device with adjustable upper and lower relational members. U.S. Patent 5,499,633, 19 Mar. 1996.
[30]R. G. Paimisano, Mandibular advancement device. U.S. Patent 2005/0028826 A1, 11 Aug. 2004.
[31]J. H. T. Mark Van Dyke, “Mandibular advancement splint. U.S. Patent: 2011/0220125 A1, 15 Mar. 2011.
[32]Scott A. Huge, Arlen J. Hurt, G. Dischinger, “Herbst orthodontic appliance with improved pivot. U.S. Patent 6.
[33]H. H. Lee, Finite Element Simulations with ANSYS Workbench 12, GOTOP Information Inc., May. 2010.
[34]Carl E. Misch, Comtemporary Implant Dentistry, Mosby Elsevier, 2008
[35]K. NISHIGAWA, E. BANDO and M. NAKANO “Quantitative study of bite force during sleep associated bruxism, Journal of Oral Rehabilitation, vol. 28, pp.485-491, 2001.

連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top