研究主題 Researches

2018研製神經性膀胱異常患者之泌尿監控裝置與智慧管理系統

臨床上,脊髓損傷(SCI)造成神經性膀胱功能異常患者,因無法感受尿意,故必須控制飲水量及間歇性導尿(CIC)將膀胱排空,若無適時導尿會導致膀胱過度膨脹、泌尿系統併發症等。根據SCI患者問卷訪談統計,導尿的時間控制、外出如廁尋找不便與飲食攝取量控制是造成患者生活不便,品質下降的主要原因。然而,至今並無一套穿戴式膀胱護理之智慧設備。有鑑於此,本研究開發一套系統分為膀胱監控與照護管理兩個部份。第一部份利用超音波建置小型穿戴式泌尿監控裝置(UMD),藉由量測膀胱前後壁的距離推估膀胱蓄尿量。第二部份透過手機應用程式鏈結Google Map與雲端資料庫建立一套智慧管理系統(IMS),提供導尿時間計時、無障礙廁所尋找、歷史紀錄與照護建議、導尿量量測等四項功能,幫助患者改善臨床導尿困擾。泌尿監控裝置實驗結果顯示,裝置在隔著24 mm皮膚與脂肪假體,能有效偵測橫向直徑(TD)為6至12公分的膀胱假體訊號變化,訊號推估結果與實際TD誤差皆為5 mm內,表示此訊號可估算容積並設閥值提醒排尿。智慧管理系統實驗結果顯示,在6位SCI患者使用智慧管理系統10天後填寫滿意度問卷,問卷評分級距由低到高依序為1-5分,平均分數結果為4.26分,代表這項系統對於改善SCI患者導尿困擾具有相當程度的有效性。藉由本次實驗結果,研究未來將進行人體臨床實驗,期待本研究提出的裝置能幫助患者掌握導尿時機,並與智慧管理系統作整合,提高身障者生活品質與健康,並作為未來臨床長照膀胱護理醫療之用。

 

In clinical, neuropathic bladder dysfunction in spinal cord injury (SCI) patients need to control of water intake and clean intermittent catheterization (CIC) because of the loss of urinary reflex. If they don’t do CIC, they will lead to Bladder swelling and complications of the urinary system. According to the SCI patient questionnaire statistics, the main reasons for the inconvenience and the decline in quality of life are control of urination time, difficult to find the wheelchair accessible, and control of dietary intake. However, there is still no single wearable device for bladder care so far. In that case, this study developed a system that separated into two parts, the functions of bladder monitoring and care management. The first part used ultrasound to development of a small wearable urinary monitoring device (UMD), which could estimate the storage of the bladder urine by measuring the distance between the anterior and posterior walls of the bladder. The second part linked to Google Map through app and the cloud database to create an intelligent management system (IMS). It could provide four functions: catheterization timekeeping, seeking the wheelchair accessible, historical records, care advices, and urine measurement. The results of the UMD test showed that the device attached the skin and fat phantom of 24 mm, it could detect the transverse diameter (TD) is 6 to 12 cm signal change of bladder phantom. And, both the signal estimation and the actual TD error are within 5 mm so that the signal could be set Threshold values to remind urination. The results of the IMS test showed that the satisfaction questionnaire was completed after 10 days of 6 SCI patients using this system; the scores of the questionnaires were 1-5 points from low to high, and the average score was 4.26. Representing this system has considerable effectiveness for Improving SCI patients with urination problem. Based on the results of this experiment, the study will conduct human clinical trials in the future. The device could help patients grasp the timing of urination and integrate with the IMS to improve the quality of life and the health of the disabled. Moreover, it could be used as a future clinical long-term bladder care medical treatment.

 

           陳競一