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  1. NTU Theses and Dissertations Repository
  2. 電機資訊學院
  3. 生醫電子與資訊學研究所
請用此 Handle URI 來引用此文件: http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66445
完整後設資料紀錄
DC 欄位值語言
dc.contributor.advisor張璞曾
dc.contributor.authorYuan-Chun Lanen
dc.contributor.author藍元君zh_TW
dc.date.accessioned2021-06-17T00:36:11Z-
dc.date.available2017-02-16
dc.date.copyright2012-02-16
dc.date.issued2012
dc.date.submitted2012-02-03
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31. Pitson D, Chhina N, Knijn S, et al. (1995) Mechanism of pulse transit time lengthening during inspiratory effort. J Ambul Monit 8:101–105,
32. Naschitz JE, Sabo E, Naschitz S, Shaviv N, Rosner I, Rozen- baum M, Gaitini L, Ahdoot A, Ahdoot M, Priselac RM, El- dar S, Zukerman E, Yeshurun D. Hemodynamic instability in chronic fatigue syndrome: Indices and diagnostic significance. Semin Arthritis Rheum 2001; 31: 199–208.
33. Naschitz JE, Sabo E, Naschitz S, Rozenbaum M, Rosner I, Musafia-Priselac R, Shaviv N, Ahdoot A, Ahdoot M, Gaitini L, Eldar S, Yeshurun D. Fractal analysis and recurrence quantifica- tion analysis of heart rate and pulse transit time for diagnosing chronic fatigue syndrome. Clin Autonom Res 2002; 12: 264– 272.
34. Naschitz JE, Rosner I, Rozenbaum M, Fields M, Isseroff H, Babich JP, Zuckerman E, Elias N, Yeshurun D, Naschitz S, Sabo E. Disease-related phenotypes of cardiovascular reactivity as as- sessed by fractal and recurrence quantitative analysis of the heart rate and pulse transit time. Q J Med 2004; 97: 141–151.
35. Malliani A, Pagani M, Lombardi F, Cerruti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991; 84: 482–492.
36. Nitzan M, Babchenko A, Khanokh B, Landau D. The variability of the photoplethysmographic signal – A potential method for the evaluation of the autonomic nervous system. Physiol Meas 1998; 19: 92–102.
37. Pitson DJ, Sandell A, van den Hout R, Stradling JR. Use of pulse transit time as a measure of inspiratory effort in patients with obstructive sleep apnoea. Eur Respir J 1995; 8: 1669–1674.
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39. R.P. Smith, J.Argod, J.L. Pepin, P.A. Levy 1999. Pulse transit time: An appraisal of potential clinical applications. Thorax 54: 452-458
40. Liu wei. Chong, Fok-Ching A Study of the Correlation of Pulse Wave Transit Time and Heart Rate Variability during Anesthesia. Master thesis NTU BEBI, 2010
41. Pal-Chun Lee, Yuan-Chun Lan, Fok-Ching Chong The Pulse Monitoring in Anesthesia by Multi-Channel Physiological Signal Measuring System. Master thesis NTU EE, 2008
42. Chia-Chi Wu, Yuan-Chun Lan, Fok-Ching Chong Multi-Channel Electrical Physiological Signal Measuring System. Master thesis NTU EE, 2008
43. M. Stevanov, J. Baruthio, B. Eclancher 2000. Fabrication of elastomer arterial models with specified compliance. J Appl Physiol 88:1291–1294
dc.identifier.urihttp://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66445-
dc.description.abstract麻醉可在手術過程中提供止痛,肌肉鬆弛,昏迷。異丙酚(propofol)是是常使用的麻醉劑,但不可避免的會使血管擴張。當血管擴張過多或無法忍受時,會導致在一些危重病人致命的後果。目前有許多方法用於檢測血管擴張的方法,但他們是侵入性的。在這篇論文中,我們提出了一個模型:一個非侵入性的方法,利用脈搏波傳導時間檢測異丙酚所引起的動力學血管擴張。 PTT (pulse transit time)是脈衝波的傳遞時間,這期間,是表示在同一心動週期的兩個動脈部位之間傳播。這項研究是使用PTT來測量異丙酚對血管系統的影響。我們收集的數據,從70名健康婦女,年紀28-51年歲,在全身麻醉下進行婦科手術。全身麻醉誘導異丙酚注射液(2mg/kg)。PTT的測量是從 R波心電圖和到食指的脈搏波(photoplethysmograph)。量測兩個 PTT值:注射前和注射異丙酚後,以 student’s t -test結果進行分析。結果: 異丙酚注射後,PTT延長,且其前後的變化統計學意義。 (P <0.05)。PTT的改變與血管擴張的程度相似。 PTT的監測發現不僅可以偵測血管的變化幅度,也可以顯示其峰值和藥物作用時間。將異丙酚放入我們的模型,我們得出結論 PTT是一個可以放入監測異丙酚的藥物動力學模型。
未來可以利用PTT量測出健康人的數值在。再和利用熱稀釋方式所量測血管動力學的數值做比較,建立PTT更準確地用在病人身上。也可以用在不同藥物對血管的影響或治療
zh_TW
dc.description.abstractAnesthesia offers pain relief, muscle relaxation and unconsciousness during surgery. Propofol is the one of the most common used among the anesthetic agents but it results in unavoidable vasodilatation which may lead to lethal consequences in hemodynamically unstable patients. Many methods have been used to detect the complication but they are all invasive. In this thesis, we propose a non invasive method using pulse wave transit time to detect propofol-induced vasodilatation. PTT is the duration of time during which a pulse wave travels between two arterial sites within the same cardiac cycle. It is used to examine propofol’s effects on vascular system. Methods. Data is collected from 70 healthy women, between 28 to 51years old, receiving gynecological surgery under general anesthesia. The general anesthesia was induced with propofol injection (2mg/kg). PTT measurements were obtained from the R wave of electrocardiogram and pulse wave of photoplethysmograph. Two PTT values were obtained; one before (the control) and the other after propofol injection. The results were analyzed by Student's T-test. Results. After propofol injection, the PTT was prolonged. The change of the PTT value from that of baseline was significant statistically. (P<0.05, by Student’s T-test). The PTT change over time correlated with the degree of vasodilatation over time. PTT monitoring revealed not only the magnitude of vascular changes but also demonstrated the onset of vascular dilation, its peak and duration. We therefore conclude that PTT is a useful guide in monitoring the phamocokinetics of propofol.en
dc.description.provenanceMade available in DSpace on 2021-06-17T00:36:11Z (GMT). No. of bitstreams: 1
ntu-101-D97945005-1.pdf: 2548533 bytes, checksum: 720dfc953777846f9b53992c3bb866ac (MD5)
Previous issue date: 2012
en
dc.description.tableofcontents謝辭…………………………………………………………………………………………………………………..…壹
中文摘要………………………………………………………………………………………………………………貳
Abtract …………………………………………………………………………………………………………………...i
CHAPTER 1 INTRODUCTION………………………………………………………………………………….1
1.1 Background…………………………………………………………………………………….….……………….1
1.2 Motivation……………………………………………………………………………………………..….……….1
1.3 Purpose …………………………………………………………………………………………………….……….3
1.4 Dissertation Organization………………………………………………………………………………………5

CHAPTER 2 A SYMPATETIC TONE MODEL OF VASODILATATION ……………………7
2.1 General anesthesia…………………………………………………………………………….……………..7
2.2 Mechanism and physiology of general anesthetic drug -- propofol--……………………….8
2.3 Vascular tone control mechanisms model………………….……………………………………….14
2.4 Amplifier or broadcast: sympathetic system influenced by propofol input………………..16
2.5 Methods of measurement of vascular tone (compliance) output……………………………18
2.5.1 Pulmonary arterial catheter………………………………………………………………………………18
2.5.2 Invasive arterial catheter………………………………………………………………………………….20
2.5.3. Non-invasive ultrasonic measurement of peripheral vascular resistance method………..22
2.5.4 Plethysmographic peripheral vascular resistance…………………………………………………..23
2.6 Pulse transit time …………………………………………………………………………….……………..23

CHAPTER 3 MATERIALS AND METHODS
3.1 Hardware…………………………………………………………………………….………………………….27
3.2 Software…………………………………………………………………………….…………………………..31
3.3 Patients …………………………………………………………………………….…………………………..33
3.4 Drug…………………………………………………………………………….……………………………….33
3.5 Data Acquisition…………………………………………………………….……………………………….34
3.6 Data Analysis ; Statistical method…………………………………….…………………………..……34
CHAPTER 4 RESULTS ………………………………………………………….………………………………36
4.1 Statistical data………………………………………………………….……………………………………..36
4.2 Figures of results………………………………………………………….………………………………….38
4.3 Table of results………………………………………………………….…………………………………….39
CHAPTER 5. DISSCUSION……………………………………………….…………………………………….40
5.1 equations……………………………………………….……………………………………………………….40
5.2 propofol in the model……………………………….……………………………………………………….42
5.3 drugs in the model……………………………….……………………………………………………………43
CHAPTER 6. Conclusion, Limitation, Future work…………………………………………………………44
REFERENCES……………………………….……………………………………………………..…………………46
dc.language.isoen
dc.subject異丙酚zh_TW
dc.subject麻醉劑zh_TW
dc.subject麻醉zh_TW
dc.subject脈搏波傳導時間zh_TW
dc.subjectanesthesiaen
dc.subjectpropofolen
dc.subjectPTTen
dc.title以非侵入脈波傳遞時間來偵測PROPOFOL引發之動態血管擴張zh_TW
dc.titleA non-invasive method using pulse wave transit time to detect propofol-induced kinetic vasodilatationen
dc.typeThesis
dc.date.schoolyear100-1
dc.description.degree博士
dc.contributor.oralexamcommittee郭德盛,林昭傑,林啟萬,余松年,詹曉龍
dc.subject.keyword麻醉,異丙酚,麻醉劑,脈搏波傳導時間,zh_TW
dc.subject.keywordanesthesia,propofol,PTT,en
dc.relation.page51
dc.rights.note有償授權
dc.date.accepted2012-02-03
dc.contributor.author-college電機資訊學院zh_TW
dc.contributor.author-dept生醫電子與資訊學研究所zh_TW
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