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仿恥骨直腸肌式人工肛門括約肌系統(tǒng)

Mechanical bionicartificial anal sphincter system

作者: 李曉陽  顏國正  吳浩  靳文天 
單位:上海交通大學電子信息與電氣工程學院醫(yī)學精密工程與智能儀器研究所(上海200240)
關鍵詞: 人工肛門括約肌;無限能量傳輸;壓力傳感器;智能控便;血供安全 
分類號:R318.6
出版年·卷·期(頁碼):2016·35·4(406-412)
摘要:

目的 國內(nèi)外一直在探尋肛腸的奧秘以及救助肛門失禁病患的辦法,開展了許多人工肛門括約肌系統(tǒng)的研究。本文設計了一種仿恥骨直腸肌式的新型人工肛門括約肌系統(tǒng),以解決現(xiàn)有人工肛門括約肌系統(tǒng)存在的血供不足、無“便意”感知以及沒有安全且穩(wěn)定的能量供給等問題。方法 系統(tǒng)主要功能為通過自制壓力傳感模塊提取腸道周圍壓力信息,傳遞至微型處理器,最終控制括約肌執(zhí)行結(jié)構(gòu)實現(xiàn)排便操作。其關鍵技術(shù)包括括約肌執(zhí)行機構(gòu)內(nèi)側(cè)嵌入超薄自制生物壓力傳感器實時感知腸道壓力變化,根據(jù)此壓力參數(shù),系統(tǒng)智能識別便意并實現(xiàn)排便預警。系統(tǒng)采用仿人體機制的運作方式并且結(jié)合血供壓力的采集模塊,能有效避免出現(xiàn)局部高壓導致腸道缺血性壞死。系統(tǒng)采用無線能量傳輸方式提供能量實現(xiàn)安全供能。結(jié)果 采用淀粉糊狀物以及水來驗證括約肌執(zhí)行結(jié)構(gòu)對糊狀以及液態(tài)糞便的夾持效果,結(jié)果表明夾持狀況良好。通過體外腸道動物實驗得到了模擬腸道周圍的壓力信號與“便意”產(chǎn)生的關系,驗證了系統(tǒng)能夠在排便閾值達到以后實現(xiàn)報警,進而提醒患者進行排便操作。實驗表明,通過使用無線供能的方式以及低功耗處理,可使系統(tǒng)每次充電后工作6.2天。結(jié)論 通過實驗驗證表明系統(tǒng)可有效控制排泄物,并成功建立排便感知信號,實現(xiàn)智能控便。

Objective The anorectal mystery and ways to rescue the anal incontinence patients are explored to solve the anal incontinence problem. This paper designs a new artificial anal sphincter system as an imitation of puborectalis muscle type. Methods In this system, an imitation of puborectalis muscle type of artificial anal sphincter is devised, with several embed biological pressure sensors to percieve the pressure of intestinal canal. According to the pressure parameter, the system could intelligently recognize the awareness of the defecation and offer an alarm to the patient. The system adopts bionic principle and combines with blood pressure acquisition module to effectively avoid the partial high pressure leading to intestinal ischemic necrosis. And the transcutaneous energy transmission is adopted to provide the energy in a biosafety way. Results Starch paste and water are used to verify the paste and liquid manure clamping effect of sphincter implementation structure and the results show that holding is in good condition. Through isolated intestinal animal experiment, we can see the relationship between the simulated intestinal pressure signals and ‘means’, and verify that the system can realize alarm after defecation threshold is reached and remind the patient to carry out operation of defecation. The system can work 6.2 d after every charging with a wireless energy supply way and a low power consumption. Conclusions The results of in vitro experiments indicate that the system can control the facel and rebuild the defecation successfully.

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