新一代反馈式人工肛门括约肌系统的研究  

Research of a novel biofeedback artificial anal sphincter system

作　　者：刘志强[1] 颜国正[1] 克磊[1] 翁晓靖[1] 

机构地区：[1]上海交通大学电子信息与电气工程学院医学精密工程与智能仪器研究所,上海200240

出　　处：《仪器仪表学报》2013年第5期1173-1180,共8页Chinese Journal of Scientific Instrument

基　　金：国家自然科学基金(30800235);教育部博士点基金新教师基金(20070248094);上海交通大学“医工(理)”交叉研究基金(YG2009ZD103)资助项目

摘　　要：近年,国内外开展了人工肛门括约肌系统的研制,为临床上根治大便失禁提供全新的方法和手段,但现有的系统在假体结构、便意重建和血供安全方面存在诸多缺点。为此,设计了反馈式人工肛门括约肌系统,其柱囊式括约肌假体采用生物材料制作,内置生物压力传感装置重建便意感知,实现排便报警,手持遥控端,控制双向滚轮式医用微泵定量地抽吸储液囊腔中的液体,从而实现假体对肠壁的咬合和释放。系统采用集成化封装,并经皮能量传输对体内系统供电。然后,从血供安全角度出发,借助猪大肠离体实验推导出阈值,并经活体动物实验,考察肠道血供安全、植入技巧和动物管理等信息。离体实验表明,系统能够有效地抑制肠道内容物渗漏,实现了对肠壁咬合压力的均匀分布(6.22～7.16 kPa),从血供安全的角度确定了排便阈值(12.9 kPa)并重建了反馈式排便感知;活体动物实验验证了可行性和有效性,运行稳定。Recently,the research on artificial anal sphincter system is progressing both in China and abroad,which provides a new method in clinic treating fecal incontinence;however,the existing systems have various defects in prosthesis struc- ture,reconstruction of defecation awareness and safety of blood supply. Therefore, a biofeedback artificial anal sphincter system is designed,in which biocompatible materials are used to make a pillar-bag-style anal sphincter prosthesis ;a bio- pressure sensor is embedded to rebuild the awareness of defection and defection warning is achieved. With a handheld re- mote control, a bi-direction roller medical micro-pump is manipulated to pump liquid in or out of the fluid reservoir quanti- tively,the bowel surrounded by the prosthesis is occluded or released, and the restraining or freeing bowel contents are achieved. The system adopts integrated package ,transcutaneous energy transmission is used to power the internal system. Then ,the threshold value is deduced in vitro test of pig bowel from the perspective of blood supply safety. Finally ,safety of bowel blood supply,implant skill and animal management are further investigated through animal experiment in vivo. The vitro experiment indicates that the system can hold the fecal, and the occlusion pressure between prosthesis and bowel is evenlydistributed （around 6.22 -7.16 kPa）. Moreover,considering likely risk of ischemic injury to the bowel,the defeca- tion threshold is selected as 12.94 kPa,and the defecation awareness is reconstructed. In vivo animal experiment verifies the feasibility and effectiveness of the proposed system;and the system operates stably.

关 键 词：人工肛门括约肌 血供 生物反馈控制 动物实验 经皮能量传输 

分 类 号：R318.14[医药卫生—生物医学工程]