自動控制留置肛管之研發

Abstract

本研究旨在研發一套讓無法自理的大便失禁病患使用的自動控制留置肛管。市面上的氣囊肛管依舊需要人力提供充放氣，並且在插管時依靠觸覺插入，所以本研究研發一套可自動充放氣同時可視的肛管，可增加使用肛管的安全性，而且護理人員可減低工作量。 為達上述目的，本研究首先探討相關文獻以建立理論基礎，使用氣囊導管連接自動充放氣模組，插管時將內視鏡放入模擬導管的中空位置，連接顯示裝置(Android智慧型裝置或電腦)觀察插管時的情況，避免損傷腸壁；自動充放氣模組特徵點在於採用Arduino Nano開發板控制充氣馬達對氣囊導管氣囊充氣，通過導通電子排氣閥電源來閉氣，防止充氣時氣囊的漏氣，並且可通過Arduino開發板控制充氣時間、自動放氣倒數時間，並且在確認肛管固定，不會滑出體外，測試防漏狀態，放氣倒數結束時，截止電源讓電子排氣閥放氣，確保裝置的運作正常。 本研究並針對各項功能進行實驗檢驗，經由資料分析後，獲致結果如下： 一、本研究自動充氣功能在對氣囊導管自動充氣，充氣時間為1秒時，平均直徑在20.8mm，充氣時間為1.5秒時，平均直徑在25.07mm，因腸道內可固定的直徑為25mm，故選1.5秒充氣時間作為自動充氣設定時間。 二、本研究之氣囊導滑落實驗平均在10分鐘時平均滑落距離為0.88mm，在15分鐘時平均滑落距離為1.07mm，在本次實驗中均無滑落出模擬腸道外。 三、本研究之防漏測試實驗排便量在100ml時成功防止外漏87%的排便量；在150ml排便量時成功防止外漏92.7%的排便量；在200ml排便量時成功防止外漏97.5%排便量，由實驗可知防漏至少可達87%。 四、本研究之肛門插管實驗中，只有第一次在190mm且0o時有障礙物掉落，其他實驗中均無掉落的狀況。 五、本研究之放氣實驗中，自動放氣時間分別為10分鐘、15分鐘以及20分鐘，放氣實際時間與設定自動放氣時間誤差分別為2.1%、0.1%以及1.6%，因自動放氣時間的實際放氣時間在15分鐘時誤差小，精準度可達97.9%，故本研究選擇他作為放氣時間的設定。This study aimed to develop a system that provides automatic care for patients that have incontinence in the indwelling anal canal. To date, the available systems in the market for indwelling anal canal care are still in the form of human-operated inflatable and deflate air balloon mechanism. This study introduces an automatic system that will at the same time provide a visual feedback for nurses or family members during intubation. This allows a more safe process and a reduced burden during patient care. A relevant related literature review was done in order to establish the theoretical basis. This includes systematic review of the following mechanism and process: from the use of balloon catheter that is connected to the automatic inflation and deflation module; mechanism of intubation and usage of endoscope through catheter simulations; connection of display device (Android devices or Personal Computers) to provide visual feedback during intubation and avoid damage to the intestinal wall; characterization of the automatic inflation and deflation module by using Arduino Nano via conduction of electronic exhaust valve power to prevent balloon deflation, control of inflation time, automatic deflation time on the target anal canal fixation, and precise position in the body; testing of leaky state, end of deflation, and time to turn off power from the electronic exhaust valve to ensure proper operation of the unit. Data analysis results from the experiments conducted are followed: 1. The experiment of automatic inflatable function, inflatable time of 1 second, the average diameter are 20.8mm, inflatable time of 1.5 seconds, the average diameter of 25.07mm because the intestine can be fixed diameter of 25mm so that the research choose 1.5 seconds inflatable time as automatic inflatable setting time. 2. The experiment of the balloon slip test average distance slip in 10 minutes is 0.88mm, at 15 minutes, the average distance slip is 1.07mm, in this experiment did not fall out of the simulated intestinal. 3. The experiment of the leak test defecation on 100ml success to drainage 87% of the defecation; 150ml defecation success to drainage of 92.7% of the defecation; 200ml defecation in the successful drainage of 97.5%, in this experiments show that leakage can be as high as 87%. 4. In anal intubation experiments, only the first time intubation at 190mm and 0∘ when there are obstacles fall, no other experiments in the fall of the situation. 5. In deflation experiment, the automatic deflation time was setup the time at 10 minutes, 15 minutes and 20 minutes. The actual time of deflation and the time of automatic deflation setup time deviation were 2.1%, 0.1%, and 1.6%. The actual deflation time of the deflation time is small at 15 minutes and the highest accuracy is 97.9%. Therefore, this study chooses him as the deflation time setting.