臺灣博碩士論文加值系統

美國婦產科醫師學會（ACOG）建議孕婦在懷孕第28週開始計數胎動，孕婦每日的胎動次數是臨床可以用於判讀胎兒狀況的依據之一，但此方法非常耗時，且計數時容易受環境或主觀意識影響，而導致計數結果並不客觀。至今臨床上卻無一套簡易的胎動量測儀器，尤其是可以同時偵測胎動位置與大小的穿戴裝置。本研究提出一種整合多點慣性感測與非同步分析方法，建立一套穿戴式長時胎動量測裝置。透過每個慣性感測器(IMU)的訊號振幅強度與時間差，搭配非同步分析方法來推估胎動發生的位置與大小。裝置使用醫療級矽膠服貼於孕婦肚皮表面，配戴相當舒適，訊號最後可以藉由藍芽4.0傳輸至電腦顯示及儲存。為了驗證裝置的可行性，本研究自製了一套孕婦假體系統擬出胎動的訊號，該假體可以模擬的胎動平均距離誤差為0.28 cm，並可藉由控制馬達轉軸設定出不同的胎動大小。假體實驗測試結果顯示，單點慣性感測器於孕婦肚皮模擬上，最大感測靈敏度為8 cm的距離。在2-4個慣性感測器的實驗中發現，3個與4個具有相當高的量測準確度，分別為87.5±7.2%與90.8±8.6%，且沒有統計上的差異。希望本研究所提出的裝置，能成為孕婦計數胎動的工具，並將所記錄下來的胎動資訊，提供臨床上大數據的分析；醫師將能藉此掌握更多胎兒的相關訊息，往精準醫療的方向邁進。

The American Congress of Obstetricians and Gynecologists (ACOG) recommended that pregnant women could begin to count fetal movements at 28th week of pregnancy. Daily fetal movement counting was one of the criteria that could be used clinically to assess the condition of the fetal during pregnancy. However, the method was a very time-consuming process, and it was easy to be influenced by the environment or subjective consciousness, which would lead to counting results were not objective. So far there has been no simple measuring device for fetal movement in clinical trials, especially the wearable device that could simultaneously detect the position and force of the fetal movement. This study proposed an integration method of multi-IMU sensing and non-synchronous analysis to develop a wearable long-term fetal movement device. Through the amplitude and time difference of the IMU signal, and combined the non-synchronous analysis to assess the position and force of the fetal movement. The device was attached to the surface of the pregnant woman's belly with a medical silicone patch, which was quite comfortable to wear. The signal could finally be transmitted to the computer for on-screen displays and storage via Bluetooth 4.0. In order to verify the feasibility of the proposed device, this study produced a set of maternal phantom system to carry out the simulation of fetal movement signals. The phantom could carry out the simulation of the mean distance error of fetal movements was 0.28 cm, and could set different forces of fetal movements by controlling the motor shaft. The results of phantom experiment show that the single-point IMU sensor had a maximum sensing sensitivity of 8 cm. Within the experiments of 2 to 4 IMU sensors, about 3 to 4 IMU sensors had high-accuracy measurement, which were 87.5±7.2% and 90.8±8.6%, respectively, and there was no statistical difference. It is hoped that the proposed device could be used as a tool for pregnant women to count fetal movement, and the recorded information of fetal movement would be provided as the big data analysis in clinical trials. Moreover, obstetricians would be able to grasp the related information of fetal and reduce the risk of unexpected accidents.

摘要 I
ABSTRACT III
致謝 V
目錄 VI
圖目錄 IX
表目錄 XII
第一章 緒論 1
1-1 前言 1
1-2 研究背景 4
1-2-1 胎兒生長的介紹 4
1-2-2 胎動的介紹 5
1-2-3 目前胎動量測的方式 7
1-3 研究動機與目的 10
1-3-1 計數胎動的重要 10
1-3-2 台灣婦產科醫療危機 12
1-3-3 可攜式醫療監測裝置與居家照護的設計概念 13
1-3-4 居家照護面臨的問題與設計需求 13
第二章 文獻回顧 16
2-1 胎動的相關研究 16
2-2 應用生理參數量測胎動 19
2-3 本實驗室子宮收縮量測之先前研究成果 22
2-4 目前市售量測胎動的相關產品 23
2-4-1 中國傳世未來公司 23
2-4-2 美國Bloomlife公司 24
第三章 系統架構與原理 25
3-1 系統架構 25
3-2 慣性感測器(INERTIAL MEASUREMENT UNIT, IMU) 26
3-2-1 胎動量測訊號處理流程 26
3-2-2 IMU分時多工(Time division multiplexing, TDM) 27
3-2-3 IMU校準程序 28
3-2-4 IMU互補式濾波 29
3-2-5 IMU非同步分析演算法 31
3-3 壓力感測器 33
3-3-1 壓力感測器之電路設計 34
3-4 孕婦腹部模擬系統設計 34
3-4-1 史都華平台之設計與公式推導 37
3-4-2 電動推桿之設計 43
3-4-3 孕婦假體系統模擬之胎動位置計算 44
3-5 穿戴式裝置開發 45
3-5-1 ATmega328P微控制晶器(microcontroller, MCU) 45
3-5-2 硬體電路設計 45
3-5-3 穿戴式外殼設計 47
3-5-4 使用者介面設計 47
第四章 結果與討論 49
4-1 實驗設計架構 49
4-2 假體系統測試 50
4-2-1 假體系統之胎動位置實驗(A1) 50
4-2-1-1 假體系統之胎動位置計算結果 52
4-2-1-2 假體系統之胎動位置討論 54
4-2-2 孕婦假體之腹壁位移量實驗(A2) 54
4-2-2-1 假體之腹壁位移量結果 56
4-2-2-2 假體之腹壁位移量討論 57
4-3 穿戴式裝置測試 58
4-3-1 IMU感測靈敏度實驗(B1) 58
4-3-1-1 IMU感測靈敏度實驗結果 59
4-3-1-2 IMU感測器靈敏度討論 60
4-3-2 多點IMU準確度比較實驗(B2) 60
4-3-2-1 多點IMU準確度比較實驗結果 62
4-3-2-2 多點IMU準確度比較討論 63
第五章 結論與未來展望 65
5-1 結論 65
5-2 未來展望 66
參考文獻 67

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