- 學位論文
利用多生理訊號探討熱凝療法之療效
The Evaluation of Radiofrequency coagulation efficacy by Multiple Physiological Parameters
摘要
動機:疼痛治療的目的在於緩解疼痛的效果，大部分病患對於止痛治療，最擔心 的就是副作用問題。尋求療效高、副作用最低的治療，所以神經外科會建議使用 的緩解疼痛的方式就是「熱凝療法」，熱凝療法是以電磁波及熱能針對神經節進 行阻斷，熱凝療法在神經外科上已被廣泛的使用，但熱凝療法的療效一直未被有 效的評估，目前針對熱凝療法療效的評估上，多以視覺類比刻度（visual-analog scale, VAS）進行評估，VAS 量表對於老年人與無法表達的患者會有不便，如此 會讓疼痛評估會出現誤差，所以需要有更客觀的熱凝療法療效的評估方式。 目的:本研究藉由擷取生理訊號，針對熱凝治療前後的療效進行探討，並量測治 療前後的 VAS。以及利用心電圖 (Electro-cardiography, ECG)探討治療前後心律 變異度的改變（Heart rate variability, HRV），且記錄膚電反應(Galvanic skin response, GSR)和光體積變化描記圖(Photoplethysmography, PPG)，並針對相關參 數與療效探討。 方法:本研究收取 60 位慢性疼痛患者，並將患者分為實驗組與控制組各 30 人， 硬體設計方面包含 ECG、PPG 以及 GSR 的生理訊號擷取裝置與資料擷取介面 卡，同步擷取十分鐘受測者在療程前後的心電圖、光體積變化描記圖和膚電反應 三種生理訊號，再透過 LabVIEW 軟體分析計算出自主神經活性相關的 LF、HF 參數值，最後使用 SPSS 統計軟體進行統計分析治療前後心率、RR 間期與自主 神經活性的顯著差異性。 結果:統計結果得知視覺類比刻度尺數值有顯著下降，雖然控制組、PPG 與 GSR 沒有顯著差異存在，但在實驗組的心電圖中代表自主神經的參數值在治療前後有 顯著的差異性，表示治療後交感神經參數下降與副交感神經參數上升的趨勢，此 結果代表著患者的疼痛在接受熱凝治療後有緩解的情形發生。
並列摘要
Abstract Background: The chronic pain effect many patients , the purpose of pain treatment is to relieve the effect of pain, most of the patients for analgesic treatment, and they worried about the side effects. Radiofrequency coagulation is the lowest side effects and high efficacy thermotherapy. However, due to differences between individuals filled, quantitating subjective sensation of pain it is very difficult. So how to assess pain cure level is a important issue to be resolved. Purpose:The study investigated the effect of Radiofrequency coagulation treatment on the autonomic nervous activity in patients with drtected the electrocardiography (ECG), photoplethysmography (PPG) and galvanic skin response(GSR) signal for before and after Radiofrequency coagulation treatment. The aim of this study was to find the Radiofrequency coagulation treatment Efficacy for the chronic patients. Methods: This study collected experimental group and control group each 30 patients. The study measured the Radiofrequency coagulation chronic patients before and after treatment ECG, PPG and GSR three physiological signals processed by LabVIEW software analysis. Final used the SPSS statistical software (Statistic Package for Social Science, SPSS) analysis for statistical analysis. And focus on on three physiological signals in Radiofrequency coagulation before and after treatment efficacy were discussed. Results: Results statistical analysis showed that the VAS of the result has significant of decline. And ECG statistical analysis showed that autonomic nervous changed activity for cure the chronic pain level .Final proved the Radiofrequency coagulation treatment efficacy. Key Word: Radiofrequency coagulation、ECG、PPG、GSR