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  1. NTU Theses and Dissertations Repository
  2. 工學院
  3. 機械工程學系
請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/36885
完整後設資料紀錄
DC 欄位值語言
dc.contributor.advisor劉正良
dc.contributor.authorWei-Ling Hongen
dc.contributor.author洪偉翎zh_TW
dc.date.accessioned2021-06-13T08:20:57Z-
dc.date.available2005-07-21
dc.date.copyright2005-07-21
dc.date.issued2005
dc.date.submitted2005-07-19
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[5] 脊髓損傷者身心重建手冊,中華民國脊髓損傷者聯合會主編,內政部補助發行,台北市,1998
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[9] 麥麗敏,廖美華,鐘麗琴,戴瑄,祁業榮和黃玉琪,簡明解剖生理學,第三版,匯華圖書出版公司,pp. 229-284,1998
[10] Ann Arbor, Autonomic Neuroscience from Bench to Bedside, http://www.wlap.org/wl-repository/umich/cacr/grand-rounds/20040514-umwlap001-01-robertson/real/sld027.htm
[11] P. Engel and G. Hildebrandt, “Long-term studies about orthostatic training after high spinal cord injury,” Paraplegia, vol. 14, pp. 159-164, 1976
[12] K. W. Hammell, Spinal cord injury rehabilitation, Chapman & Hall, pp. 95-96, 1993
[13] F. Gonzalez, J. Y. Chang, K. Banovac, D. Messina and A. A. Martinez, “Auto-regulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury,” Paraplegia, vol. 29, pp.1-7, 1991
[14] B. P. Olaf, S. Svend, and E. Lars, “Cerebral autoregulation,” Cerebrovascular and Brain Metabolism Review, vol. 2, pp.161-192, 1990
[15] I. J. Schatz, “Orthostatic hypotension: diagnosis and treatment,” Hospital Practice Aprll, pp. 59-69, 1984
[16] M. B. Histand and C. W. Miller, “Transcranial doppler ultrasound for cerebral perfusion,” Acta Physiological Scandinavica, Supplementurn, vol. 625, pp.1-44, 1995
[17] H. Stevens, and J. Fazakas, “Experimentally indued hypotension,” Arch Neurol Psych, vol. 73, pp. 416-418, 1955
[18] Jon Mukand, Luba Karlin, Korrey Barrs and Paula Lublin, “Midodrine for the management of orthostatic hypotension in patients with spinal cord injury : a case report,” Arch Phys Med Rehabil, vol. 82, pp. 694-696, May 2001
[19] Thomas E. Groomes and Chi-Tsou Huang, “Orthostatic hypotension after spinal cord injury : treatment with fludrocortisone and ergotamine,” Arch Phys Med Rehabil, vol. 72, January 1991
[20] Robertson D. and Davis TL. “Recent advances in the treatment of orthostatic hypotension,” Neurology, Suppl. 5, pp. 26~32, 1995
[21] Robertson D., “ Disorders of autonomic cardiovascular regulation: baroreflex failure, autonomic faileure, and orthostatic intolerance syndromes,” Hypertension: pathology, diagnosis, and management, New York, Raven, pp. 941-962, 1995
[22] Naso F., “Cardiovascular problems in patients with SCI,” Phys Med Rehabil Clin, vol. 33, pp. 741-749, 1992
[23] Onrot J, Goldberg MR and Hollister AS, “Management of chronic orthostatic hypotension,” Am J Med, vol. 80, pp. 454-464, 1986
[24] Michael J. Brennan and Linda T. Miller, “Overview of treatment options and review of the current role and use of compression garments, intermittent pumps, and exercise in the management of lymphedema,” Cancer, vol. 83, pp. 2821-2827, Dec 1998
[25] Enrico Di Girolamo, Cesare Di Iorio, Luigi Leonzio, Panfilo Sabatini and Antonio Barsotti, “Usefulness of a tilt training program for the prevention of refractory neurocardiogenic syncope in adolescents,” Circulation, vol. 100, pp. 1798-1801, 1999
[26] Ector H., Reybrouck T., Heidbuchel H., Gewillig M. and Van de Werf F., “Tilt training: a new treatment for recurrent neurocardiogenic syncope and severe orthostatic intolerance,” Pacing Clin Electrophysiol, vol. 21, pp. 193-196, Jan 1998
[27] Olaf Oldenburg, Andreas Kribben, Dietrich Baumgart, Thomas Philipp, Raimund Erbel and Michael V. Cohen, “Treatment of orthostatic hypotension,” Current Opinion in Pharmacology, vol. 2, pp. 740-747, 2002
[28] S. F. Figoni, R. M. Glaser, M. M. Rodgers, S. P. Hooker, B. N. Ezenwa, S. R. Collins and et al., “Acute hemodynamic responses of spinal cord injured individuals to functional electrical stimulation-induced knee extension,” Journal of Rehabilitation Research and Development, vol. 28, No. 4, pp. 9-18, 1991
[29] S. C. Naaman, R. E. Stein and C. Thomas, “Minimizing discomfort with surface neuromuscular stimulation,” Neurorehabilitation and Neural Repair, vol. 14, No. 3, pp. 223-228, 2000
[30] Ahmed S. Elokda, David H. Nielsen and Richard K. Shields, “Effect of functional neuromuscular stimulation on postural related orthostatic stress in individuals with acute spinal cord injury,” Journal of Rehabilitation Research and Development, vol. 37, No. 5, pp. 535-542, Sep 2000
[31] Evan E. Sampson, Robert S. Burnham, and Brian J. Andrews, “Functional electrical stimulation effect on orthostatic hypotension after spinal cord injury,” Arch Phys Med Rehabil, vol. 81, pp. 139-143, 2000
[32] Ivy O. W. Man, Gila S. Lepar, Matthew C. Morrissey and Jozef K. Cywinski, “Effect of neuromuscular electrical stimulation on foot/ankle volume during standing,” Medicine & Science in Sports & Exercise, vol. 35, No. 4, pp. 630-634, April 2003
[33] N. Labropoulos, D. S. Oh, E. Golts, S. S. Kang, M. A. Mansour and W. H. Baker, “Improved venous return by elliptical, sequential and seamless air-cell compression,” International Angiology, vol. 22, No. 3, pp. 317-321, Sep 2003
[34] Andrzej Szuba, Radha Achalu and Stanley G. Rockson, “Decongestive lymphatic therapy for patients with breast carcinoma-associated lymphedema,” Cancer, vol. 95, issue 11, pp. 2260-2267, Dec 2002
[35] 溫展雄,改變下肢循環器程序以協助姿勢性低血壓病患減輕暈厥問題之研究,台灣大學機械工程學研究所碩士論文,台北市,2003
[36] 陳惠芳,以希伯特黃轉換分析脊髓損傷病患起坐性暈厥之心率變異度,中原大學醫學工程學研究所碩士論文,pp. 47,台北市,2001
dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/36885-
dc.description.abstract高位脊髓損傷病患因自律神經傳導障礙,導致姿勢改變時,產生姿勢性低血壓,並併發眼花、暈眩的狀況。為研究對下肢加壓是否可幫助姿勢性低血壓患者改善暈眩狀況,本研究利用一套具控制系統之下肢加壓循環器,以可量化的生理參數量測為判斷基準,變更不同的氣壓幫浦壓力,將積存於患者下肢的血液壓回上肢,以延長患者的站立時間,並針對受試患者於不同傾斜床角度與不同氣壓幫浦壓力下之生理參數進行分析。經實驗結果證實,血壓會因傾斜床角度昇高而逐漸降低,也會因施加於下肢之幫浦壓力增加而昇高,下肢加壓循環器應用在治療因脊髓損傷所造成姿勢性低血壓之方面,的確可以有效的改善姿勢性低血壓。zh_TW
dc.description.abstractOne of the major complications in individuals with spinal cord injury (SCI) is orthostatic hypotension. Patients with SCI above T6 interrupt the sympathetic pathways from brain stem to sympathetic nerves and disrupt the voluntary muscle contractions of the lower extremities. Therefore, these patient may suffered from impairment of blood pressure control in the responses to postural change and severe venous pooling in the lower extremities. The purpose of our research is to try to use the Circulator Pumping System of Lower Extremities (CPSLE) to alleviate the orthostatic hypotension in subjects with SCI and to research the effect of changing the pumping pressure and the angle of tilt table in individuals with SCI.
The results showed this CPSLE could alleviate orthostatic hypotension in individuals with SCI. The blood pressure of patients decreases by the degree of tilt table increasing, and the blood pressure increases by the pumping pressure increasing.
en
dc.description.provenanceMade available in DSpace on 2021-06-13T08:20:57Z (GMT). No. of bitstreams: 1
ntu-94-R92522612-1.pdf: 2364378 bytes, checksum: f1b55eb8ecbaf862837f5fce62b0a3aa (MD5)
Previous issue date: 2005
en
dc.description.tableofcontents致謝 ……………………………………………………………………一
摘要 ……………………………………………………………………三
Abstract ………………………………………………………………..四
目錄 ……………………………………………………………………五
圖目錄 …………………………………………………………………九
表目錄 ………………………………………………………………一五
第一章 緒論 ………………………………………………….……….1
1.1 研究動機 …………………………………………….………...1
1.2 研究目的 …………………………………………….………...2
1.3 論文架構 …………………………………………….………...2
第二章 文獻回顧 ………………………………………….……….4
2.1 脊髓神經作用 …………………………………….…………...4
2.2 脊髓損傷 ………………………………………….…………...6
2.3 自主神經與心臟血管循環 ……………………….…………...7
2.4 姿勢性低血壓 …………………………………….…………..10
2.5 治療姿勢性低血壓的方式 ……………………….…………..12
2.6 CPSLE於物理治療上的應用 ………………………………....15
第三章 研究方法與系統架構 ……………………………………..17
3.1 研究流程 ……………………………………………………...17
3.2 研究之應用對象 ……………………………………………...19
3.3 人體生理資料庫參數 ………………………………………...19
3.4 擠壓程序 ……………………………………………………...21
3.5 系統架構 ……………………………………………………...22
第四章 軟硬體連結與實驗方法 ………………………………....25
4.1 硬體連結 ……………………………………………………...25
4.1.1 傾斜床控制裝置 ……………………………....25
4.1.2 下肢加壓循環器 ……......................27
4.1.3 生理監視器 …………………………………....28
4.1.3.1 血壓量測計 ………………….....29
4.1.3.2 心電圖量測計 ……………….....31
4.1.3.3 SpO2量測器 ………………….....33
4.2 軟體工具 ……………………………………….............34
4.2.1 氣壓擠壓程序程式 ………………………......35
4.2.2 生理監視器程式 …………………………......38
4.2.3 心電訊號降頻與分析計算程式 …………......40
4.3 實驗方法 ……………………………………………….......42
4.4 實驗流程 ……………………………………………….......43
4.4.1 無氣壓幫浦加壓下肢之實驗 ………………....43
4.4.1.1 實驗前準備工作 …………….....44
4.4.1.2 實驗步驟 …………....45
4.4.1.3 實驗完成後之資料處理.46
4.4.2 不同氣壓幫浦加壓下肢之實驗 …………......46
4.4.2.1 實驗前準備工作 …………….....47
4.4.2.2 實驗步驟 ………......47
4.4.2.3 實驗完成後之資料處理 48
第五章 實驗結果 ………………………………………………....49
5.1 受試患者之資料 ………………………………....49
5.2 高位脊髓損傷受試者之實驗結果 ……………....50
5.2.1 C3受試患者實驗結果 ……….......50
5.2.2 C5受試患者實驗結果 ……….......59
5.2.3 T5受試患者實驗結果 ………….....66
5.3 非高位脊髓損傷受試者之實驗結果 …………....74
5.3.1 T11受試患者之實驗結果 ………....74
5.3.2 T12受試患者之實驗結果 ………....82
5.3.3 L2受試患者之實驗結果…………....89
5.4 討論 …………………………………………......97
5.4.1 實驗結果比較 ……………………...97
5.4.1.1血壓結果比較 ………...98
5.4.1.2心跳頻率結果比較 ....101
5.4.2 於不同傾斜床角度下幫浦壓力與血壓之研究 …......103
5.4.3 瘀痕現象…………………………...111
第六章 結論與建議 ……………………………………………...113
6.1 結論 ……………………………………………...113
6.2 未來發展之建議 ………………………………...114
參考文獻 ………………………………………………………....117
附錄一 ..…………………………………………………........125
附錄二 ………………………………………………………......129
dc.language.isozh-TW
dc.title下肢加壓循環器幫浦壓力變化對脊髓損傷患者姿勢性低血壓之影響之研究zh_TW
dc.titleStudy of the Effect of Orthostatic Hypotension in Patients with Spinal Cord Injury by Changing the Pumping Pressure of Compression Pumping System of Lower Extremitiesen
dc.typeThesis
dc.date.schoolyear93-2
dc.description.degree碩士
dc.contributor.oralexamcommittee陳適卿,賴建宏,王富正
dc.subject.keyword脊髓損傷,姿勢性低血壓,下肢加壓循環器,血壓,傾斜床角度,幫浦壓力,zh_TW
dc.subject.keywordorthostatic hypotension,spinal cord injury(SCI),the pumping pressure,circulator pumping system of lower extremities (CPSLE),en
dc.relation.page158
dc.rights.note有償授權
dc.date.accepted2005-07-19
dc.contributor.author-college工學院zh_TW
dc.contributor.author-dept機械工程學研究所zh_TW
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