| Summary: | 碩士 === 國立臺灣大學 === 生醫電子與資訊學研究所 === 101 === Spinal cord injury is often accompanied with detrusor external urethral sphincter (EUS) dyssynergia, which may lead to low efficiency of micturition function and incomplete voiding, and increase the risk of urinary tract infection in the patients. Being under this symptom for a long period, a patient may also develop ureteral edema, renal damage, and even renal failure.
Electrical neural moderation is one of the new treatment directions. It can provide the function that the damaged nerve originally does and improve the voiding efficiency. So it is critical to detect the status of bladder and give the muscle electrical stimulation at the right time. Nowadays clinical detection of the bladder status depends on urodynamic study, such as using external ultrasound to estimate the volume of the bladder, or placing a catheter through the urinary tract to measure the intravesical pressure. But external ultrasound can-not give the electrical neural moderation an immediate feedback; neither is it suitable for patients to catheterize for a long period. The objective of this study is to use EUS-electromyography (EMG) as detector of the bladder status. EMG signal is filtered and amplified by a 5-stage circuit, and processed by using a LabVIEW algorithm. A moving window method is used to decrease time delay and maintain moderated sensitivity of the algorithm, realizing a real-time detection of the bladder status. The algorithm is applied on normal rats and rats with spinal cord injury experimentally.
From experimental result analyzed by ROC method, using EUS-EMG to detect the bladder status compared with real voiding status, the accuracies of voiding detection exhibit 97% in normal rats and 90.3% in those with spinal cord injury. The accuracies of both results are better than that from using intravesical pressures as detector. Those findings demonstrate the feasibility of this study. Signal output function of the DAQ card can be used to trigger functional electrical stimulation, which improves voiding function of patients with spinal cord injury.
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