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系統識別號 U0026-1208201114422900
論文名稱(中文) 建構心房中隔缺損關閉術之心導管手術流程模擬裝置
論文名稱(英文) Development of a Cardiac Catheterization Simulator for ASD Procedures
校院名稱 成功大學
系所名稱(中) 醫學工程研究所碩博士班
系所名稱(英) Institute of Biomedical Engineering
學年度 99
學期 2
出版年 100
研究生(中文) 李育政
研究生(英文) Yu-Jeng Li
學號 p86984099
學位類別 碩士
語文別 英文
論文頁數 39頁
口試委員 指導教授-陳天送
共同指導教授-謝凱生
口試委員-陳家進
口試委員-陳培展
口試委員-陳世中
中文關鍵字 心房中隔缺損  心臟內超音波  虛擬實境 
英文關鍵字 Atrial Septal Defect (ASD)  intracardiac echocardiography (ICE)  Virtual Reality (VR) 
學科別分類
中文摘要 臨床上使用心導管手術搭配閉合器來治療第二型心房中隔缺損已是首選方式,術中併用心臟內超音波觀察心房結構,具有不需全身麻醉之優勢。然而二維心臟內超音波影像不易評估心房立體結構與中隔缺損狀況,對於新進臨床醫師具有一定的困難度。傳統的臨床教學多以術中一對一方式進行教學,此種方式容易造成新進臨床人員缺乏反覆練習的機會,且對手術安全具有爭議與顧慮。本研究將發展一套利用虛擬實境技術模擬心導管手術的訓練系統,此系統不但能提供執行此類手術醫生不斷練習的平台,讓其熟悉手術的各個程序,並對各類突發狀況有正確的處置方式。另外,更有幾項操作時參數的記錄,例如:完成手術的時間、執行氣球擴張術時錯誤的次數與錯誤處理…等等。在完成系統建構同時,我們設計一套完整的心房中隔缺損關閉術的心導管手術實驗,其中,包括導絲、導管、氣球導管的操作以及安普拉茲閉合器的放置。最後,邀請三位具備執行心房中隔缺損關閉術知識但沒有實際臨床手術經驗的人員參與實驗。過程中,先觀察受測者於操作流程的順序是否正確,接著是執行氣球導管擴張術的測試,最後記錄完成模擬手術的時間。根據實驗結果數據顯示,在操作順序的正確率與完成模擬手術的時間都有所提升。未來更可以與現今台灣醫學教育做一結合,成為一套完善的教學平台與示範工具。
英文摘要 Transcatheter device closure is one of the treatments for secundum type atrial septal defect (ASD) in clinical operation currently. The advantage of transcatheter device closure with intracardiac echocardiography (ICE) guidance can avoid general anesthesia. However, clinicians need to image the 3D structure and ASD of the heart during the operation, and there may be higher risk during the procedure. Thus it is rather difficult for inexperienced clinicians to learn the operation procedure. Usually, new physicians don’t have adequate opportunities for practicing ASD surgery, because the most common mode of teaching is a manner of one-to-one during the procedure of operation. It’s controversial and scrupulous for surgery safety. For the purpose of clinical training, this study developed a simulation system of cardiac catheterization and ASD closure procedure with the Virtual Reality (VR) technique. With this system, clinicians can repetitively practice the procedure of the cardiac catheterization and ASD closure. Steps of the procedure will be learned and potential risks could be avoided before treatment. Finally, we invite three subjects to participate the experiments in this study and the results indicate that the performances of proposed system demonstrated greater efficiency and higher accuracy in clinical training for cardiac catheterization in ASD.
論文目次 摘要 I
Abstract II
致謝 III
Chapter 1 Introduction 1
1.1 Motivations and the aims of this study 1
1.1.1 Introduction to ASD 2
1.1.2 The characteristic of VR technology 3
1.1.3 Introduction to ICE 6
1.2 Literature review 6
Chapter 2 Methodology 12
2.1 System design 12
2.1.1 Encoder 13
2.1.2 Load cell 15
2.2 Hardware design 16
2.3 User interface 19
2.4 The program flowchart 19
2.5 Calibration of displacement and rotation measurement 20
Chapter 3 Results and Discussions 23
3.1 Catheter movement simulation 24
3.2 Catheter rotation simulation 24
3.3 Perturbation of blood simulation 25
3.4 Balloon inflation simulation 25
3.5 Amplatzer implementing 26
3.6 User interface 26
3.7 Operation sequence flowchart 30
Chapter 4 Conclusions 33
References 34
Appendix 37
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