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研究生:陳志忠
研究生(外文):Chih-Chung Chen
論文名稱:經皮雷射椎間盤減壓術之暫態熱傳分析與模擬
論文名稱(外文):The Transient Heat Transfer Analysis and Aimulation of Percutaneous Laser Disc Decompression
指導教授:林大偉林大偉引用關係
指導教授(外文):David T.W. Lin
口試委員:林大偉胡毓忠黃崇能鄭博仁陳樺翰陳斌豪
口試委員(外文):David T.W. Lin
口試日期:2015-07-20
學位類別:博士
校院名稱:國立臺南大學
系所名稱:機電系統工程研究所
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:136
中文關鍵詞:經皮雷射椎間盤減壓術(PLDD)椎間盤突出症微創手術Pennes方程式生物熱傳導
外文關鍵詞:percutaneous laser disc decompression (PLDD)intervertebral disknerniation,Pennes equation
相關次數:
  • 被引用被引用:0
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  • 下載下載:16
  • 收藏至我的研究室書目清單書目收藏:0
本研究的主要目的是為了探討經皮雷射椎間盤減壓術(PLDD)進行時的有效性及安全性,以及椎間盤在不同溫度、不同雷射功率、不同含水量而導致不同熱傳係數( )及不同雷射手術時間受熱時的各種條件,所對應產生應力與應變之探討與分析。
脊椎病變是常見的病症之一,主要是由於椎間盤退化病變所引起,本研究以多重物理量分析軟體進行三維立體模擬經皮雷射椎間盤減壓手術,由模擬可知:在經皮雷射椎間盤減壓手術進行過程中,雷射路徑的各髓核觀測點的溫度變化,由結果可發現,髓核在受熱後應力值及應變量是非常小的,而血液灌注率會使髓核之應力及應變下降,當提高雷射功率或延長雷射手術時間時,髓核溫度與應力應變會隨之增大,由結果顯示雷射功率的改變量對髓核溫度及應力應變的改變,遠大於雷射手術時間的效應,而不同年齡層髓核含水量多寡,對於髓核溫度及應力應變的影響,相對於雷射功率改變量或雷射手術時間的長短,是較不顯著的。
在臨床經驗與資料越來越豐富的時代,希望能與實際的PLDD手術數據互相比較,使本研究的結果對往後在治療椎間盤突出症時,可以更精確、更有效率的做好手術前的準備工作,使手術更具可靠性及安全性。

The purpose of this study is to discuss the temperature and stress distribution problem of the interverbral disc while the surgical operation of PLDD is processing. This study also further discuss the water content of disc changes with age to cause variation of thermal conductivity thermal expansion coefficient specific heat and related parameters, and the effect of thermal conductivity related about the patient’s age will be illustrated. The 3D thermal structure conjugated model of the multiphysics analysis algorithm is used to understand the temperature and stress distribution of the whole domain and heat transfer phenomena under the different kinds of laser heating rate and patients. The temperature profile of the intervertebral disk is obtained and reveals the relations among the parameters. The temperature profile is predicted as the heat transfer phenomena can be handled on the surgical process. In the future, we expect that this result can be used to handle the PLDD in the pre-surgical simulation.
摘要 I
Abstract III
致謝 IV
目錄 V
表目錄 VII
圖目錄 IX
符號說明 XVI
第一章緒論 1
1-1 前言 1
1-2 研究動機與目的 6
第二章文獻回顧 8
2-1 Pennes生物組織熱傳微分方程式 8
2-2 脊椎醫學的研究 10
2-3 PLDD的演進 13
第三章數學理論與模型建構 20
3-1 有限元素分析法 20
3-2 統御方程式 23
3-3 邊界條件 25
3-4 髓核模型建構 26
第四章結果與討論 33
4-1 模擬手術結果 33
4-2 雷射手術時間與雷射功率對髓核溫度之影響 36
4-3 髓核含水量對髓核溫度之影響 42
4-4 椎間盤k值對髓核溫度之影響 59
4-5 手術時間與雷射功率對髓核應力的影響 60
4-6 髓核含水量對髓核應力之影響 65
第五章總結與未來展望 125
5-1 結論 125
5-2 總結 126
5-3 未來展望與建議 127
參考文獻 129
自述 136

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