臺灣大學: 醫學工程學研究所趙福杉蔡芳生F.S.Tsai, VincentVincentF.S.Tsai2013-03-292018-06-292013-03-292018-06-292011http://ntur.lib.ntu.edu.tw//handle/246246/254749身為泌尿科醫師，我們經常會遇到與醫學工程有關的臨床問題。本論文介紹了三個要解決的泌尿科臨床問題，接著試著去找出醫學工程相關的解決方案。此三個問題分別為：實現在家測量精子品質、安全的陰莖電刀手術、以及經尿道前列腺刮除術之術中監測系統。 男性不孕症隨著工業化的發展有愈來愈嚴重的趨勢，同時它也影響著一半左右的不孕症夫妻。因此，針對那些想讓妻子懷孕或者正在接受不孕症治療的男性而言，密集的檢測精子品質是有必要的。在本文中，利用分析法與實驗法去描繪出人類精液的一個基本特性---電阻抗頻譜。基於此一特性，一種可實現在家測量精子品質的微流道精子檢測儀得以實作完成並提供關於精子的泳動力與密度的訊息。 電刀手術在泌尿科的使用雖起源於19世紀，然而我們對陰莖的基本電氣特性卻瞭解有限。在本文中陰莖的組織中的電阻抗、電流密度、以及電場強度會利用串連與並連的模型與電流分流分析法加以推導分析。同時，特別針對此電氣特性與陰莖電刀手術安全性的關係有詳細的討論。 前列腺(又稱為攝護腺)良性肥大是老年男性常見的疾病。經尿道前列腺刮除術被視為治療前列腺良性肥大的金標準。然而此一手術有下列兩個問題會影響手術的安全：刮除後尿道直徑的測量與出血量的估算。在本文中利用測量玻璃量杯中液體的電阻抗可模擬估算刮除後尿道的直徑大小，同時利用偵測密閉/開放引流系統的電阻抗變化亦可模擬估算術中的出血量。基於此結果， 未來可望發展出應用在人體上的經尿道前列腺刮除術之術中監測系統。 藉著以上三個醫學工程相關的應用實例，結合醫學工程與其他臨床醫學的應用是值得我們持續研究，同時也期待此一結合能為學界帶來更多的創新發展。As urologists, we encountered clinical problems which were biomedical engineering related. This dissertation introduced three clinical problems to be solved and tried to find out the biomedical engineering solutions for those problems. They are home-use sperm counting, safe electrosurgery for human penis and a monitoring system for transurethral resection of prostate (TURP) operation. Male infertility is a progressive problem with the industrialization and influences nearly half of those infertile couples. It is necessary to frequently monitor sperm quality of a male, who intends to achieve conception or is in his treatment for infertility. A basic characteristic for human semen--- electrical impedance spectrum was depicted by both analytical and experimental methods. Based on the electrical impedance of sperm, a home-use microfluidic sperm counting device was developed, which can provide information of sperm motility and concentration. Although electrosurgery for urology has been used since the 19th century, the basic electrical characteristics of penis are still not well documented. The resistivity, current density and electrical field strength of penile tissues were derived by series and parallel models, and electrical-current division analysis. Additionally, the safety for penile electrosurgery according to the electrical characteristics of penis was discussed in detail. Benign prostate hyperplasia (BPH) is a common disease among elder males. TURP is considered the golden standard for treating BPH. Estimation of the resected urethral diameter and estimation of blood loss are the two common problems occurring in TURP and complicate the operation. Utilizing impedance measurement of fluid in glass cylinders, the simulated diameter of urethra can be estimated well. By measuring the change in impedance of a closed/irrigating system, the simulated blood leakage can be quantified. An in vivo TURP monitoring system would be developed based on the results of this experiment. With these three examples of applications of biomedical engineering on urological problems, it is concluded that the combination of biomedical engineering and other clinical sciences is worthy for further study and promising for innovative research and development.1715984 bytesapplication/pdfen-US精子品質電阻抗頻譜男性不孕症微流道電刀手術陰莖經尿道前列腺刮除術Sperm qualityElectrical impedance spectrumMale infertilityMicrofluidic channelElectrosurgeryPenisTransurethral resection of prostate[SDGs]SDG3thesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/254749/1/ntu-100-D95548013-1.pdf