【摘要】：無創(chuàng)正壓通氣相對于傳統(tǒng)通氣方法，具有無創(chuàng)傷、患者痛苦小、產(chǎn)生相關(guān)并發(fā)癥幾率小和恢復(fù)周期短等特點(diǎn)。臨床研究發(fā)現(xiàn)，，使用面罩進(jìn)行無創(chuàng)正壓通氣適應(yīng)于一部分全身麻醉的患者。但是手術(shù)期間，醫(yī)生需要長時間托住患者頭部，這需要付出很大的體力勞動，并且容易導(dǎo)致通氣不穩(wěn)定，從而限制了面罩通氣的使用。因此很有必要設(shè)計一款機(jī)械臂，用于輔助醫(yī)生固定患者頭部，使其可以采用面罩進(jìn)行無創(chuàng)通氣。對于這種輔助醫(yī)療機(jī)械臂，國內(nèi)外還未出現(xiàn)相關(guān)研究，這更增加了研究的迫切性。 本文根據(jù)臨床醫(yī)生提出的需求，研究了國內(nèi)外關(guān)于手術(shù)麻醉期間氣道護(hù)理的現(xiàn)狀以及幾款主動式和被動式醫(yī)療機(jī)械臂。在此基礎(chǔ)上，設(shè)計了一款用于輔助醫(yī)生對患者進(jìn)行面罩通氣的被動式機(jī)械臂。該機(jī)械臂具有3+1個自由度，被動式控制，各關(guān)節(jié)鎖緊方便、安全、可靠。 作者首先進(jìn)行機(jī)械臂總體方案、機(jī)械結(jié)構(gòu)和各關(guān)節(jié)鎖緊方式的設(shè)計。根據(jù)醫(yī)生的操作過程和需求，確定機(jī)械臂的設(shè)計要求和控制方式。通過構(gòu)型綜合，確定機(jī)械臂為三自由度串聯(lián)構(gòu)型。綜合國內(nèi)外現(xiàn)有的關(guān)節(jié)鎖緊方式，最終確定第一關(guān)節(jié)鎖緊方式為電動鎖緊，其余三個關(guān)節(jié)為電磁鎖緊。根據(jù)機(jī)械臂工作空間確定機(jī)械臂各桿長。針對第一關(guān)節(jié)電動鎖緊機(jī)構(gòu)進(jìn)行了巧妙的設(shè)計，最終完成所有關(guān)節(jié)元器件的選型。對整套機(jī)械臂的機(jī)械結(jié)構(gòu)進(jìn)行了詳細(xì)的設(shè)計，并對關(guān)鍵零部件進(jìn)行強(qiáng)度校核。 針對第一關(guān)節(jié)的電動鎖緊方式進(jìn)行計算。根據(jù)Hertz接觸理論和摩擦理論應(yīng)用材料力學(xué)和彈性力學(xué)相關(guān)知識對摩擦面的斜度進(jìn)行理論計算。在Workbench中建立摩擦面接觸的二維模型，進(jìn)行有限元分析。推導(dǎo)適合本課題鎖緊模型的鎖緊力矩公式，獲取接觸面上一定數(shù)量點(diǎn)的摩擦應(yīng)力值，計算鎖緊力矩。 最后對單只機(jī)械臂的控制系統(tǒng)進(jìn)行總體方案設(shè)計和相關(guān)實驗研究。根據(jù)需求，確定無線遙控鎖緊方式，完成各控制單元的設(shè)計選型。采用大功率驅(qū)動器驅(qū)動三個電磁離合器，設(shè)計第一關(guān)節(jié)鎖緊力可調(diào)。通過實驗驗證機(jī)械臂能否完成相應(yīng)的設(shè)計功能，完成了機(jī)械臂各關(guān)節(jié)鎖緊力實驗，鎖緊等級標(biāo)定實驗以及臨床實驗。
[Abstract]:Compared with traditional ventilation, noninvasive positive pressure ventilation (NIPPV) has the characteristics of no trauma, little pain, low incidence of related complications and short recovery period. Clinical studies have found that the use of masks for non-invasive positive pressure ventilation is suitable for patients under partial general anesthesia. But during the operation, doctors need to hold the patient's head for a long time, which requires a lot of physical labor, and easily lead to unstable ventilation, which limits the use of mask ventilation. Therefore, it is necessary to design a mechanical arm to assist the doctor in fixing the patient's head so that it can be ventilated with a mask. For this kind of auxiliary medical manipulator, there is no related research at home and abroad, which increases the urgency of research. According to the demands of clinicians, the present situation of airway nursing and some active and passive medical manipulators at home and abroad were studied. On this basis, a passive manipulator is designed to assist doctors in ventilating patients with mask. The manipulator has 31 degrees of freedom, passive control, convenient locking of joints, safety and reliability. At first, the author designs the general scheme, mechanical structure and locking mode of each joint. According to the operation process and requirements of the doctor, determine the design requirements and control mode of the manipulator. Through configuration synthesis, it is determined that the manipulator is in series configuration of three degrees of freedom. The first joint locking mode is electric locking and the other three joints are electromagnetic locking. The length of each arm rod is determined according to the workspace of the manipulator. The first joint electric locking mechanism is designed skillfully, and all the joint components are selected. The mechanical structure of the whole manipulator is designed in detail, and the strength of the key parts is checked. The electric locking mode of the first joint is calculated. According to Hertz contact theory and friction theory, the slope of friction surface is calculated by applying the knowledge of mechanics of materials and elasticity. The two-dimensional contact model of friction surface is established in Workbench and finite element analysis is carried out. The locking torque formula suitable for the locking model of this subject is derived, the friction stress values of a certain number of points on the contact surface are obtained, and the locking torque is calculated. Finally, the control system of single manipulator is designed and tested. According to the demand, the wireless remote control locking mode is determined to complete the design and selection of each control unit. Three electromagnetic clutches are driven by high power driver, and the locking force of the first joint is adjustable. The corresponding design function of the manipulator is verified by experiments. The locking force experiment, the calibration experiment of locking grade and the clinical experiment of the joint locking force of the manipulator are completed.
【學(xué)位授予單位】：哈爾濱工業(yè)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：TP241

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