體外加強反搏治療裝置開發;Development of Enhanced External CounterPulsation Devices

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题名:	體外加強反搏治療裝置開發;Development of Enhanced External CounterPulsation Devices
作者:	曾元泓;Zeng, Yuan-Hong
贡献者:	生物醫學工程研究所
关键词:	心臟衰竭;反搏;冠狀動脈灌流;體外加強反搏
日期:	2022-09-23
上传时间:	2022-10-04 11:08:50 (UTC+8)
出版者:	國立中央大學
摘要:	心臟衰竭(英語:Heart Failure，HF)又稱為心力衰竭，簡稱心衰。一般意指慢性心臟衰竭（chronic heart failure，CHF），同義於鬱血性心力衰竭（congestive heart failure）；當心臟無法泵送足夠血流量維持身體所需時，會導致一系列生理症狀產生。而侵入性治療有冠狀動脈血管整形術、安裝主動脈內氣球幫浦、加裝心臟節律器、冠狀動脈繞道手術、安裝心室輔助器甚至是心臟移植等。體外加強反搏治療系統(Enhanced External CounterPulsation，簡稱EECP) 為一種非侵入性且安全的治療方式，此項治療可增加冠狀動脈血流量以及促進心肌代謝，對於心衰竭、心絞痛、心肌梗塞等缺血性疾病都能得到良好的改善。本研究宗旨即為開發EECP治療裝置系統，無場域限制且可依照個人所需調整療程長短。美國(AHA)及歐洲心臟學會(ESC)都建議此項治療方式可做為心臟衰竭和心血管疾病病患治療的新療程，無論短期或長期對症狀的改善均有顯著的療效。接上心導獲得ECG生理訊號，經由電腦與微處理器MCU運算，將增壓與洩壓訊號觸發電磁氣閥，由空壓機將加壓過的空氣流體高速且精準地加壓至人體下肢的壓脈帶內做動增壓功能，並於相同路徑將壓脈帶內空氣經由電磁氣閥排出做動洩壓功能。於心臟循環週期中的舒張期，下肢壓脈帶會同步施以外部壓力(大於個體收縮壓)，由小腿往大腿之順序依次施壓至目標壓力值，於主動脈瓣關閉之時，亦於冠狀動脈開始灌流之時，以逆行到達主動脈根部之反搏壓力將血液推入冠脈以增加冠狀動脈灌流；在心臟收縮期前，於下肢的壓脈帶將迅速排氣洩壓，將受擠壓之血液回充至下肢，益於外周血管的增生，並配合體內釋放的負壓增加整體心輸出量，如此讓系統週而復始運作，以改善心衰竭與其他缺血性疾病。 ;Heart failure, generally referred to as chronic heart failure (CHF), is synonymous with congestive heart failure; when the heart cannot pump enough blood flow to maintain the body′s needs, it causes a series of physiological symptoms. Invasive treatments include coronary angioplasty, installation of intra-aortic balloon pumps, addition of cardiac pacemakers, coronary bypass surgery, installation of ventricular assist devices and even heart transplantation. Enhanced External CounterPulsation (EECP) is a non-invasive and safe treatment. After this treatment, it can increase coronary blood flow and promote myocardial metabolism. It can improve ischemic diseases such as heart failure, angina pectoris, and myocardial infarction. The purpose of this research is to develop an EECP treatment device system that has no field limitation and can adjust the length of treatment according to individual needs. Both the American Heart Association (AHA) and the European Society of Cardiology (ESC) recommend this treatment as a new course of treatment for patients with heart failure and cardiovascular disease, with significant short-term and long-term improvement in symptoms. Connect the cardiac guide to obtain the ECG, through the computer and the microprocessor MCU operation, the pressurization and pressure relief signals will trigger the solenoid valve, and the air compressor will quickly and accurately pressurize the pressurized air to the pressure pulse of the lower limbs of the human body In the belt, and the air in the pulse belt is exhausted through the solenoid valve in the same path. During the diastolic phase of the cardiac cycle, the lower extremity cuffs will simultaneously apply external pressure (greater than the individual systolic pressure), and apply pressure sequentially from the calf to the thigh to the ideal pressure value. When the aortic valve closes, the blood will be pushed. Enter the coronary artery to increase coronary perfusion; before the systole, the pressure cuff in the lower extremity will quickly exhaust and release the pressure, and the squeezed blood will be returned to the lower extremity. ischemic disease.
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