心導管機械控制器之設計與分析

The Development and Analysis of Cardiac Catheterization Mechanical Controller

李嘉偉(Jia-Wei Li)

指導教授 ： 陳振山

國立臺灣大學/工學院/機械工程學研究所/碩士(2006年)

https://doi.org/10.6342/NTU.2006.02648

摘要

心臟科醫生在執行心導管手術時，最困難的地方在於血管阻塞處或是較彎曲的血管地方，必須小心且緩慢地將導引線穿透阻塞處，此一動作將花費醫生數分鐘至數小時的時間，且對醫生體力上的消耗相當大，等到導引線已穿透阻塞位置之後，再來的醫療過程將相當容易，因此，如何將導引線利用機械手臂的控制，順利並且精準的穿過血管阻塞處將是一大課題。
本文中嘗試著將心導管機械控制器設計並且實做出來，此控制器將可以代替醫生的手進行旋轉以及平移的運動模式，醫生便可在較舒適的環境下來進行手術過程。在實驗的過程中，我們發現導管及金屬導線在靜態位移量測時，輸入與輸出量得的位移量有延遲現象，並且針對相關的變形進行討論，推算出在不同的彎曲弧角及半徑比情況下，導線上的軸向力增加時會有各種不同的變形狀態發生，並在內文中詳敘討論。

關鍵字

心導管 ； 控制器

並列摘要

The biggest difficulty met by cardiology doctors when they perform endovascular surgery is that they have to get guidewire penetrated through the obstacles or the curved part of blood vein slowly as well as carefully, which takes doctors from minutes to hours to finish and often exhausts them. Once the penetration of guidewire is done, it would be easier to complete the rest of the operation. Then there comes a huge challenge for doctors – how to successfully and precisely perform this penetration operation by using the “mechanical arm” to control the movement of guidewire.
This essay provides the attempt to develop and implement cardiac catheterization mechanical controllers that will allow rotative and translative degree of freedom done by doctors, thus sparing more strength for them and making them perform operation more effortlessly. During the process of experiment, it is found that the leading end of the guidewire may not move forward the same distance as that is pushed in by the surgeon from the input end. In this essay, there will be a discussion over the associated deformation theories, deducing the variation of deformation pattern with the increasing longitudinal force based on different spans and radius ratio. A detailed discussion over this issue will also be seen in this essay.

並列關鍵字

Cardiac ； Catheterization ； Controller

參考文獻

[1] Schneider, P.A., 2003, Endovascular skills: guidewire and catheter skills for endovascular surgery, Marcel Dekker, Inc., New York.

[2] Love, A.E., 1944, A Treatise on the Mathematical Theory of Elasticity, Dover Publications, New York.

[3] http://www.kmuh.org.tw/www/hsllcwlw/Cathroom%20WebPage.htm