| Background:The morbidity of colorectal disease is increasing nowadays. Many patients who have colorectal disease have to undergo a colostomy. Patients with colorectal fistula are rising year by year. It is said that100thousand perpetual colostomy patients are increasing every year and the total number is1million now. Colostomy is a heavy burden to the patients, includes physiology psychology and economy. Patients with stoma have severe fecal incontinence, they loss the function of continence and apperception. Scholar from all over the world have used some process to recover the function of anus, for example, intensive therapy of pelvic floor muscle, biofeedback training and electric stimulation of nerve. But the effect is not well enough.The orthodox method to care of stoma was ostomy bag. It could get rid of the diachorema but had badly influence to the patient. It also had the complication of skin infection and stoma necrosis. Burcharth used a stoma plug to control faeces in1986. The plug was made of dilatation material. It could expand when it was wet and control faeces. Though the plug had certain effect, it was disposable and had some complication. The use of artificial anus occluder was a new way to get rid of stoma. But all the nursing productions have the following insufficient, not convenient nursing, easily leakage, easy to fall off and can’t autonomic regulation. So, to make an intellectual artificial anus occluder is clinical valuable.Ultrasound is a mechanical vibration in elastic medium. In includes length wise vibration and transversal vibration. Between them length wise vibration is widely used. It has the character of beam characteristics, direction propagation, strong direction, strong penetrability and its energy is stronger than the other sonic wave of the same amplitude. Various media have corresponding acoustic impedance. The higher the acoustic impedance characteristics, the better ultrasound spread. Usually, the solid has the highest acoustic impedance, followed by liquid and gas. The typical example of intestinal intent includes gas state, solid state and liquid state. The ultrasonic signal corresponding attenuation when it transmission in different intestinal content. The sensor translates ultrasonic signal into electrical signal.Simulation of sensory nerve could cognitive intestinal content by the help of ultrasonic detection and micro system and may play an important role in the near future.Objective:The object is to develop an intelligence sensory perceptual system of artificial anal occluder. The system consists of basic circuit, circuit design, software programming, hardware debug and specimen fabrication. Simulates various intestinal contents of rabbits and authenticate its effect.Methods:1. The preparation of reflection ultrasonic detecting system.Sendk type5V DC power, DT9205digital multimeter and modified reflection-type ultrasonic signal detection system were used. The system was modified of TCT40-18FS-1.2B detector. The emission frequency was2MHz and the amplifier magnification of reception circuit was48and35, respectively.The radiating circuit emits ultrasonic by the emitter and the reception circuit receives the signal. The ultrasonic signal translates into electrician signal by the help of amplifier circuit and filter circuit. The voltage value displays on the digital multimeter.There are three capture state of the water. First, the probe stays in air. Second, the probe is partial immersion. Third, the probe is totally immersion. Every state has20voltage values and SPSS is used to statistics. Repeated ANOVA is used to test whether there is significant difference. A value of P<0.05was considered statistically significant.2The abstraction of different intestinal contents by ultrasonic sensoryTwenty New Zealand white rabbits of either sex, weight (2.5±0.2) kg, provided by the Laboratory Animal Center of Southern Medical University, in the general level of the Southern Medical University Laboratory Animal Center of feeding. All surgical procedures on rabbits were carried out under sterile conditions. Anesthesia was induced and maintained with urethane (5ml/kg body weight). The rabbits were fixed in the console after successfully anesthesia. Abdominal midline incision was carried out and bowel was exposed. About10cm distal colon was dissociated20cm from the anus. Then a transverse incision was made at the end of the dissociation bowel.Following are the preparation of the intestinal contents of different state. The vacuity state, the granular stool was removed from the bowel and the ultrasonic probe was placed in and fixed. Gaseous state, air of10ml was injected into the intestinal lumen with a syringe. Solid state, air in the intestinal lumen was pulled out and granular stool from the proximal colon was push to the probe. Liquid state, saline of5ml was injected to the intestinal lumen and mixed up with the granular stool. Each state was measured randomly for five times and the observed effects were recorded accurately.The simulated sensory nerve was used to detect the voltage value of various sate. Every state has100voltage values and SPSS is used to statistics. Repeated ANOVA is used to test whether there is significant difference. A value of P<0.05was considered statistically significant.3. The preparation and use of intelligence artificial sensory system of anus occluderPreviously study had found that there were significant difference among the voltage signals and three nonoverlapping regions were existed among the four conditions. As a result, the definition of the four conditions was made through the ICC7.0program as followed,#define V GASEOUS ((295*400+500)/1000)#define V SOLID ((455*400+500)/1000)#define V LIQUID ((598*400+500)/1000)U<295mV, gaseous state, the green light shone and the alarm device vibrated, the buzzer sounded monosyllabic "beep" at the same time.295mV<U≤455mV, solid state, the blue light shone and the alarm device vibrated. Meanwhile the buzzer sounded two-syllable "beep".455mV<U≤598mV, liquid state, red light shone and the alarm device vibrated while the buzzer sounded "the urgent" when there was liquid in the bowel. U>598mV, vacuity state, the indicator light (white light) shone while the alarm device and the buzzer were in a quiescent state. The probe could receive the ultrasonic signal and translate into electric signal through microcont roller unit. Then electric signal was translated into analog signal by the help of C++language and the LED light could shine corresponding color, the alarm device could respond as well. Experimental animal, surgical procure and preparation of intestinal content were the same as above. The ultrasonic sensor was used to detect the signal of the intestinal contents,100times for each state. And the SSN could feedback according to different conditions. A "correct" was recorded if the SSN made a right judgment. Otherwise was an "error" and the detail information would be recorded as well. Totally there were400numerous collected and under statistics.Results:1. The preparation of reflection ultrasonic detecting system.The ultrasonic detecting system could capture the ultrasonic signal and translated into electrical signal. The air state (343.850±2.110mV) had the lowest voltage value and the partial immersion (637.600±8.009mV) was higher while the totally immersion (943.350±3.856mV) was the highest. There was significal difference among the three state (F=71675.880, P=0.000,<0.05). The air state (9mV) had the lowest fluctuation and the totally immersion (16mV)was higher while the partial immersion (39mV) was the highest.2The abstraction of different intestinal contents by ultrasonic sensoryThere was a significant difference among the voltage signals of the4conditions (P=0.000). Multiple comparisons showed that significant differences existed in each pair of the4conditions (P=0.000). Three signal blank regions existed in the4conditions. The gas condition (257.120±7.534mV) had the lowest voltage value and the solid condition (398.120±21.819mV) was higher. The voltage value of liquid condition (507.240±14.357mV) was still higher than solid condition while the vacuity condition (658.560±11.407mV) had the highest. There was40mV between the max of gas condition and the min of solid condition while there was30 mV between the max of solid condition and min liquid condition. The voltage value between the max of liquid condition and the min of vacuity condition was76mV.3. The preparation and use of intelligence artificial sensory system of anus occluderThe simulated sensory nerve worked well. There were99times correct and1time error in the vacuity state while there were98times correct and1time error in the liquid state. There were95times correct and5times error in solid state and no error in gas state.Conclusions:Anal incontience is restraint confused for some factor. Treatment difficulties is reconstruction. The article summerizes the research staus of artificial anal occluder and makes a reflection ultrasonic sensor which can sensory different state of intestinal content. The circuit of the sensor is made of emission circuit, reception circuit, filter circuit and amplifier circuit. It can capture ultrasonic signal and translate into electrical, distinguish various contents inside intestinal lumen and makes three forms intellect feedback. The reflection ultrasonic sensor may use inintellect artificial anal occluder in the near future. |
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