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研究生： 林純玄
Lin, Chun-Hsun
論文名稱： 反脈動左心室輔助器之離體測試
In-Vitro Test of Counter-pulsation Left Ventricle Assist Device
指導教授： 陸鵬舉
Lu, P. J.
學位類別： 碩士
Master
系所名稱： 工學院 - 航空太空工程學系
Department of Aeronautics & Astronautics
論文出版年： 2006
畢業學年度： 94
語文別： 中文
論文頁數： 66
中文關鍵詞： 左心室輔助器
外文關鍵詞： LVAD
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    • I
    中文摘要
    題目：反脈動左心室輔助器之離體測試
    研究生：林純玄
    指導教授：陸鵬舉
    本研究主要目的是藉由建造一模擬人體循環系統流路之測試平
    台，以協助反脈動左心室輔助器(Counter-Pulsation Left Ventricular
    Assist Device)的性能評估及設計修正。本文依據血液動力學分析方法
    與Windkessel 模式設計循環測試台， 經由測試台上之阻抗
    (Resistance)、順容（Compliance）及慣性項(Inertance)各個參數的調變，
    分別模擬健康與心衰竭人體之血液循環及血動力特性，並藉由反脈動
    左心室輔助器的輔助，觀察其對心衰竭情況下之人體循環輔助效果。
    在實驗中發現於心衰竭狀態下使用40 與60 毫升血泵，對心搏量
    (Cardiac Output)的增加約在11%~18%之間，然而增加血泵容量並不
    一定能有效提升心搏量的輸出。此外，本輔助器所產生的收縮卸載
    (Systolic Unloading)功能，在相位差(Phase) 108 ~ 162 之間隨著心跳頻
    率的增加，主動脈舒張終端壓力變化量(ΔEDAP)會隨之下降，顯示
    對主動脈壓力提供了卸載之效果；對於舒張強化現象(Diastolic
    Augmentation)，則在相位差(Phase) 108 ~ 252 之間隨著心跳頻率的增
    加而提升，且反脈動左心室輔助器對舒張強化的輔助效果，並不隨著
    相位的差異而有所改變。

    In-Vitro Test of Counter-Pulsation
    Left Ventricle Assist Device
    Student: Chun-Hsun Lin
    Advisor: Pong-Jeu Lu
    Abstract
    A mock circulation test rig is constructed presently, which aims to
    help the design improvement and performance evaluation of a
    counter-pulsation left ventricular assist device (LVAD). This test rig is
    designed according to the cardiovascular hemodynamics and the
    Windkessel model. By adjusting the resistance, compliance and the
    inertance of the constituent components, the circulation pertaining to
    healthy and heart failure conditions was simulated. Counter-pulsation
    circulation support under heart failure condition was simulated and
    evaluated using this mock circulation test rig. Both 40 and 60 c.c. blood
    pumps were adopted. It was observed that cardiac output was elevated
    11~18%, however, larger blood pump volume does not offer appreciably
    better cardiac output enhancement. Systolic unloading effect was found
    in the present counter-pulsation LVAD support, which is manifested by
    the end diastolic arterial pressure drop, in particular in the phase range of
    108~162 degree. Diastolic augmentation was also presented, which
    shows an increasingly enhanced trend in the phase range of 108~252
    degree. Moreover, contrary to the conventional intra-aortic balloon
    pump, the present counter-pulsation LVAD provides effective diastolic
    augmentation uniformly over the entire phase range.

    IV 目錄 中文摘要........................................................................................ I Abstract .........................................................................................II 誌謝..............................................................................................III 目錄....................................................................................... IV 表目錄......................................................................................... VI 圖目錄........................................................................................VII 符號說明..................................................................................... IX 第一章緒論...............................................................................................1 1-1 前言..............................................................................................1 1-2 循環測試平台簡介......................................................................2 1-3 反脈動左心室輔助器簡介..........................................................4 1-4 研究方法......................................................................................5 第二章循環測試平台設計理論介紹......................................................7 2-1 血液動力理論..............................................................................7 2-3 順容器........................................................................................11 2-4 慣性項........................................................................................13 第三章實驗儀器設備及實驗步驟........................................................15 3-1 實驗設備....................................................................................15 3-1-1 定常流場整流段...............................................................15 3-1-2 浮子流量計.......................................................................16 3-1-3 壓力轉換計(Pressure Transducer)....................................16 3-1-4 超音波流量計...................................................................16 3-1-5 資料擷取系統...................................................................16 V 3-1-6 壓縮系統...........................................................................17 3-2 阻抗模擬裝置校驗....................................................................17 3-2-1 實驗量測步驟與方法.......................................................18 3-3 順容器校驗................................................................................18 3-3-1 實驗量測步驟與方法.......................................................19 3-4 循環測試平台............................................................................19 3-4-1 測試段...............................................................................19 3-4-2 實驗量測步驟與方法.......................................................20 第四章實驗數據與討論........................................................................22 4-1 測試阻抗模擬裝置在定常流場下的性能曲線.........................22 4-2 測試彈簧在順容器所對應的順容值.........................................22 4-3 循環測試平台的各項數據分析.................................................23 第五章結論.............................................................................................26 5-1 結論.............................................................................................26 5-2 未來工作....................................................................................27 參考文獻.............................................................................................28 自述.....................................................................................................66 VI 表目錄 表2-1a 循環測試平台選用參數表－體循環........................................32 表2-1b 循環測試平台選用參數表－肺循環........................................33 表4-1 順容器校驗表..............................................................................34 表4-2 健康與心衰竭人體心臟功能比較..............................................35 表4-3a 40 毫升血泵在不同相位輔助下與心衰竭相較之心搏量差異36 表4-3b 40 毫升血泵在不同相位輔助下與心衰竭相較之收縮卸載效果 比較.............................................................................................37 表4-3c 40 毫升血泵在不同相位輔助下與心衰竭相較之舒張強化效果 比較.............................................................................................38 表4-4a 60 毫升血泵在不同相位輔助下與心衰竭相較之心搏量差異39 表4-4b 60 毫升血泵在不同相位輔助下與心衰竭相較之收縮卸載效果 比較.............................................................................................40 表4-4c 60 毫升血泵在不同相位輔助下與心衰竭相較之舒張強化效果 比較.............................................................................................41 VII 圖目錄 圖1-1 人體循環示意圖..........................................................................42 圖2-1a 十根管子阻抗模擬裝置............................................................43 圖2-1b 六根管子阻抗模擬裝置............................................................43 圖2-2a 主動脈順容器............................................................................44 圖2-2b 其他部位順容器........................................................................44 圖3-3 Pace maker 實體圖.....................................................................45 圖3-4a 控制器(1)正視圖........................................................................46 圖3-4b 控制器(1)前視圖.......................................................................46 圖3-5 控制器(2)實體圖.......................................................................47 圖3-6 鳳凰七號人工心臟驅動器........................................................48 圖3-1a 循環測試平台機構示意圖........................................................49 圖3-1b 循環測試平台機構實體圖........................................................50 圖3-2 定常流實驗設備實體照片..........................................................51 圖4-1 十根管子阻抗模擬裝置校驗圖(a：下壓0mm；b：下壓5mm； c：下壓8mm；d：下壓11mm)..............................................52 圖4-1(續) 十根管子阻抗模擬裝置校驗圖(a：下壓0mm；b：下壓 5mm；c：下壓8mm；d：下壓11mm) .................................53 圖4-2 六根管子阻抗模擬裝置校驗圖(a：下壓0mm；b：下壓5mm； c：下壓10mm；d：下壓12mm)............................................54 圖4-2(續) 六根管子阻抗模擬裝置校驗圖(a：下壓0mm；b：下壓 5mm；c：下壓10mm；d：下壓12mm) ...............................55 圖4-3 手閥阻抗模擬裝置校驗圖..........................................................56 圖4-4 心跳每分鐘70 下之脈動流場血壓及流量波形。(a：健康狀態； b：心衰竭狀態)..........................................................................57 VIII 圖4-5 脈動流場下健康與心衰竭之心搏量比較...................................58 圖4-6a 使用40 毫升血泵輔助主動脈壓力(AoP)圖Heart Rate:70BPM Phase=108°..................................................................................59 圖4-6b 使用60 毫升血泵輔助主動脈壓力(AoP)圖Heart Rate:70BPM Phase=108°..................................................................................59 圖4-7 心衰竭狀態下使用40 毫升血泵之脈動流場血壓及流量波形。 (a: Phase= 108 ; b: Phase= 180 ; c: Phase= 252 ) ........................60 圖4-7(續) 心衰竭狀態下使用40 毫升血泵之脈動流場血壓及流量波 形。(a: Phase= 108 ; b: Phase= 180 ; c: Phase= 252 ) ................61 圖4-8 心衰竭狀態下使用60 毫升血泵之脈動流場血壓及流量波形。 (a: Phase= 108 ; b: Phase= 180 ; c: Phase= 252 ) ........................62 圖4-8(續) 心衰竭狀態下使用60 毫升血泵之脈動流場血壓及流量波 形。(a: Phase= 108 ; b: Phase= 180 ; c: Phase= 252 ) ................63 圖4-9 在心衰竭狀態不同心跳頻率40 毫升血泵於不同相位之輔助效 果圖(a：血泵輔助狀態下不同心跳頻率之相位對心搏量關係 圖；b：血泵輔助狀態與心衰竭狀態下之心搏差異量)..........64 圖4-10 在心衰竭狀態不同心跳頻率60 毫升血泵於不同相位之輔助 效果圖(a：血泵輔助狀態下不同心跳頻率之相位對心搏量關係 圖；b：血泵輔助狀態與心衰竭狀態下之心搏差異量)..........65

    28
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