【作者】 胡又佳；

【导师】 李光；

【作者基本信息】 浙江大学 ， 生物医学工程， 2005， 硕士

【摘要】 感觉障碍是周围神经系统疾病的主要症状和体征。长期以来,临床上对周围神经系统的检查手段仍停留在定性的阶段,因此无法满足医生对感觉障碍类疾病的发展过程和治疗效果的进行细致了解和判定。从上世纪70年代后期发展起来的定量感觉检测(QST)技术是评估周围神经纤维功能的一种很好的手段,它具有无创性、操作简单等特点,它能有效辅助医生观察病人的神经病变过程。本文在前人已有的理论基础之上,进一步研究定量感觉测试的理论和技术,开发和完善自动化的定量感觉测试的仪器,探讨和研究客观检测阈值的新方法。 文章首先讨论了感觉神经功能评价的意义,回顾了其发展史,对比现在临床上神经科检查所使用的一些乎段,说明了定量感觉检测技术的重要性及优势。接下来文章详细介绍了定量感觉检测系统的理论基础,包括神经生理学基础和心理物理学基础。 文章对QST系统的上位机软件部分进行了详细解说,包括各模块的任务和流程,以及软件的测试及结果。特别是两种阈值的检出方法。一种方法是,基于传统心理物理学上的感觉阈值的操作定义,所采用的UDTR规则和强迫选择法结合的阈值检出算法;另一种是将QST系统与GSR仪联用的阈值检出方法,并在此基础上,尝试提出的一种全新的、更加客观的阈值的操作定义。 利用QST整体系统,包括上位机软件、下位机系统和GSR仪,针对两种阈值检出的方法,设计并进行两组实验。分析实验数据表明两种方法的合理性,以及两种方法下检测得到的阈值的可重复性。通过对两种方法的比较,对定量感觉检测方法下一步的研究重点进行了探讨。 最后对定量感觉检测的发展前景进行了展望。更多还原

【Abstract】 Hypoesthesia or hyperesthesia, caused by the dysfunctions to the sensory system, was examined qualitatively in the past. However, since the 1970’s a brand new method, Quantitative Sensory Testing, was developed to make the evaluations to the nerve fibres function quantitatively, which can help doctors trace the patients’ sensory. The Vibration Perception Testing System presented in this paper is one of the Quantitative Sensory Testing systems, with that two different objective methods of the vibration perception thresholds testing were discussed.First, the development and application history of quantitative sensory testing technology were reviewed, and the significance and predominance of quantitative sensory testing were discussed. Then, vibration perception testing system is introduced including two main theoretical aspects: neurology principles and psychophysical background.The PC software of the VPT system is discussed in detail, including each module and its flow. Two different definition of threshold were also introduced. One is determined by the up and down transformed rule (UDTR) and forced-choice algorithm, which are based the psychophysical theory. The other is determined by the patient’s galvanic skin response, which is a brand new redefine of the threshold. Next the software testing result is presented.Two series of clinical trials were carried out with the two methods respectively. And the data analysis proved them repeatable and reliable.Comparing the two methods, the future work of the quantitative sensory testing is discussed.更多还原