CN102512757B - Method and device for injury potential compensation after spinal cord injury - Google Patents
Method and device for injury potential compensation after spinal cord injury Download PDFInfo
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- CN102512757B CN102512757B CN201110412656.0A CN201110412656A CN102512757B CN 102512757 B CN102512757 B CN 102512757B CN 201110412656 A CN201110412656 A CN 201110412656A CN 102512757 B CN102512757 B CN 102512757B
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Abstract
The invention discloses a method and a device for injury potential compensation after spinal cord injury. The method comprises the following steps of: detecting an injury potential after spinal cord injury, observing the value of injury potential in real time, and controlling a stimulation voltage according to the observed value of injury potentials to allow the injury potential close to zero. The method achieves injury potential compensation to ensure that the spinal cord microenvironment is relatively stable. The device for implementing the compensation method comprises four stimulating electrodes, a stimulation voltage generating circuit (2), an injury potential measuring electrode, an injury potential amplifying circuit (4) and voltage display equipment (5). The stimulation voltage generating circuit (2) generates an adjustable stimulation voltage, the stimulation voltage is applied onto the spinal cord of a patient through the stimulating electrodes to stimulate the spinal cord, the injury potential measuring electrode is used for measuring an injury potential, the injury potential amplifying circuit (4) magnifies the injury potential and filters off high-frequency interference in the injury potential, the voltage display equipment (5) displays the value of magnified injury potential, and the stimulation voltage is regulated according to the value of magnified injury potential.
Description
Technical field
The present invention relates to a kind of method and device for treating after spinal cord injury, particularly a kind of method and electrostimulator thereof of injury potential compensation.
Background technology
Motion after spinal cord injury and reconstruction of sensory function are one of significant challenge of Neuroscience Research, and at present a lot of therapies are all devoted to promote the reparation of damage.From last century the mid-80, foreign scholar reported successively that using electric field stimulates and can promote neural axon to grow to negative electrode, reduces the generation of glial scar after damage, for the neuranagenesis after central nervous system injury is created good environment.In order to realize the two-way growth of injured nerve, can adopt oscillating electric field to stimulate, electric polarity exchanges once at regular intervals.Current three pairs of electrodes of the many employings of oscillating electric field stimulator, electrode is fixed on the upper and lower both sides of lesion level, be close to vertebra, the polarity of electrode of the same side is identical, thereby form electric field on the spinal cord between two electrodes, electric field is change direction at regular intervals, as United States Patent (USP) " Method and apparatus for regenerating nerves (patent No.: 4919140) " and " Apparatus and method for repair of spinal cord injury (patent No.: 6975907) ".The history of oscillating electric field stimulation therapy spinal cord injury has had more than 20 years, although clinical first phase is tested and a large amount of zooperies all shows that oscillating electric field stimulation can promote the axon regeneration after spinal cord injury, it is unknown that the mechanism of oscillating electric field stimulation promotion axon regeneration remains.Especially for damage in various degree and while implanting apart from the situations such as asynchronism(-nization) of initial damage, do not distinguished, and the selection of parameters of electrical stimulation also has no basis, this has just seriously restricted the application of oscillating electric field stimulation therapy spinal cord injury.
Injury potential is the DC potential difference existing between injury region and normal place after spinal cord injury, and it is that normal cell membrane and resting potential are destroyed, injury region Na because spinal cord microenvironment after damage changes
+, Ca
2+etc. a large amount of cationes, flow in born of the same parents, anion flows out and forms.Consequently cause Ca in cell
2+surplus, and then cause a series of biological processes, cause the secondary injury of spinal cord.In addition, injury potential and degree of injury are closely related, damage more seriously, and injury potential initial value is larger, and injury potential, along with the increase of time constantly reduces, becomes logarithmic relationship to decline.The method of after damage, spinal cord being carried out to electricity irritation can regulate ion motion direction, thereby microenvironment in body is intervened.
Summary of the invention
The object of the invention is to overcome the shortcoming of prior art, propose a kind of method and device for injury potential compensation after spinal cord injury.
The present invention proposes a kind of new spinal cord stimulation trial method, after spinal cord injury, immediately injury potential is compensated.The present invention is by the detection to injury potential after spinal cord injury, the numerical value of real-time monitored injury potential, the injury potential numerical value obtaining according to observation, by regulating the size of electricity irritation voltage, make injury potential after electricity irritation close to zero, realize injury potential compensation, thereby keep spinal cord microenvironment relatively stable.
The device electrostimulator of application the inventive method comprises stimulating electrode, stimulation voltage circuit for generating, injury potential measurement electrode, injury potential amplifying circuit and voltage display device.Described stimulating electrode has two pairs totally 4, and two positive poles in stimulating electrode are placed on the left and right sides at spinal cord injury place, and two negative poles are placed on respectively a side and the tail side at spinal cord injury place.Stimulating electrode is connected with stimulation voltage circuit for generating, and stimulation voltage circuit for generating produces adjustable stimulation voltage, and puts on patient's spinal cord spinal cord is stimulated.Described injury potential measurement electrode has 3, the head of injury potential measurement electrode is attached to respectively on the spinal dura mater of spinal cord injury place, injury region head side and injury region tail side, potential difference between injury region and injury region head side is a side injury potential, and the potential difference between injury region and injury region tail side is tail side injury potential.Three injury potential measurement electrode are connected with injury potential amplifying circuit, and voltage display device is connected with the output of injury potential amplifying circuit, for showing, amplify back side and tail side injury potential numerical value.
Stimulating electrode forms with the coiling on leading screw of thin platinumiridio silk, is solenoid shape, so can increase the contact area of electrode and organism, reduces the electric current density at electrode place.Adopt suture through solenoid, stimulating electrode and muscle to be stitched together fixing.Two positive poles of stimulating electrode are fixed on the muscle of the left and right sides, spinal cord injury place, are close to vertebra; Two other negative pole is fixed near muscle injury region head side and tail side vertebra, one of them negative pole is placed on a side of injury region, apart from the distance of two vertebral levels of injury region, another negative pole is placed on injury region tail side, is also the distance of two vertebral levels apart from injury region.
Described stimulation voltage circuit for generating consists of power supply, switch, bleeder circuit, voltage amplifier circuit and voltage follower circuit.Power supply is bipolarity DC source, and positive and negative supply voltage absolute value equates; Two switches are connected with positive and negative power supply respectively, are used for controlling closure and the disconnection of positive and negative power supply; The input of bleeder circuit is connected with two switches, and the output of bleeder circuit is connected with the input of voltage amplifier circuit, and the output of voltage amplifier circuit is connected with the input of voltage follower circuit.In bleeder circuit, utilize potentiometer to regulate its output voltage, and be input to voltage amplifier circuit and amplify, by the potentiometer in regulation voltage amplifying circuit, can realize the adjusting to amplification; Through the adjusting of two positions as mentioned above, stimulation voltage can be adjusted between positive and negative supply voltage; Voltage amplifier circuit output signal stimulates patient after voltage follower circuit and stimulating electrode again.Two negative poles in stimulating electrode are connected with the output of voltage amplifier circuit, two for anodal with " " link together.
Injury potential measurement electrode has adopted the structure of salt bridge electrode, electrode cable, stopper, calomel electrode, upper glass pipe, interior salt bridge liquid, agar, lower-glass pipe, outer salt bridge liquid and porous ceramics, consists of.Upper glass pipe and lower-glass Guan Jun are upper coarse and lower fine hollow cylindrical, and outer salt bridge liquid is housed in lower-glass pipe, and outer salt bridge liquid is normal saline, the sodium chloride solution that mass percent is 0.9%, the porous ceramics shutoff of the lower port of lower-glass pipe; Inner salt bridge liquid is housed in upper glass pipe, interior salt bridge liquid is saturated potassium chloride solution, the agar shutoff of the lower port of upper glass pipe, calomel electrode is placed in upper glass pipe, be immersed in saturated potassium chloride solution, the stopper shutoff of the upper end of upper glass pipe, one end of electrode cable is connected with calomel electrode, the other end of electrode cable passes from stopper, is connected with injury potential amplifying circuit.During use, upper glass pipe lower end is inserted in the outer salt bridge liquid in lower-glass pipe, and two glass tubings are fixed together, one end of porous ceramics shutoff is the head of injury potential measurement electrode.
Injury potential amplifying circuit comprises reference electrode, differential amplifier circuit, low-pass filter circuit and voltage follower circuit.The differential amplifier circuit being connected with measurement electrode adopts instrument amplifier, by regulating the resistance on this amplifier can realize the adjusting to amplification; The injury potential measurement electrode of injury region is connected with the inverting input of instrument amplifier, the in-phase input end of respectively with two instrument amplifiers of injury potential measurement electrode of side and tail side is connected, the side injury potential after being amplified respectively and tail side injury potential.Injury potential after amplification disturbs through low-pass filter circuit filtering high-frequency signal, then after voltage follower circuit, is connected to voltage display device, as oscillograph, circuit tester, data collecting card etc.
Utilize the operating procedure of spinal cord stimulation trial method of device of the present invention as follows:
First completely expose the dorsal part of injury region spinal cord, and the spinal cord dorsal part of injury region head side and tail side, the distance between this naked position, three places and injury region is a vertebral levels.The head of injury potential measurement electrode being attached on spinal dura mater gently.
Next constant stimulus electrode, stimulating electrode has four, and wherein two positive poles are fixed on the muscle of the left and right sides, spinal cord injury place, are close to vertebra, and two negative poles are fixed on the muscle at injury region head side and two vertebral levels places of tail side.
The 3rd pacing amount injury potential, the head of injury potential measurement electrode being attached on spinal dura mater gently during measurement.Three injury potential measurement electrode lay respectively at injury region, on injury region head side and injury region tail side spinal dura mater, observe the registration on voltage display device, open two switches of stimulation voltage circuit for generating simultaneously, spinal cord is applied to electricity irritation, and by regulating the resistance of potentiometer in bleeder circuit or voltage amplifier circuit to realize the adjustment to stimulation voltage between stimulating electrode, a side after the amplification showing on voltage display device and tail side injury potential are all close to zero time, stop regulating, realize injury potential compensation, thereby microenvironment in the body before artificial recovery damage.
The present invention can use for the electrostimulator of injury potential compensation after spinal cord injury in the operation after acute spinal cord injury.During stimulator work of the present invention, can make the injury potential that damages rear generation disappear, injury region is zero with the potential difference at normal place.Under this state, the cation outside spinal cord aixs cylinder, as calcium ion, can not flow in a large number aixs cylinder inside, kept the relatively stable of injury region spinal cord microenvironment, and then reduced the possibility of spinal cord secondary injury, also the introducing for other treatment method provides the valuable time.
Compared with prior art, the present invention has following characteristics: (1) is a kind of brand-new thinking to damaging that the injury potential of rear appearance compensates, and the present invention is based upon on this theoretical basis and also belongs to first.(2) the present invention is applied to the treatment of acute spinal cord injury, and electricity irritation can be carried out in the decompression operation after spinal cord injury in the lump.(3) according to the injury potential value measuring, stimulation voltage is regulated in real time, make the microenvironment at spinal cord injury place approach all the time poised state.
Accompanying drawing explanation
Fig. 1 the present invention is for the schematic diagram of the electrostimulator of injury potential compensation;
The structure chart of Fig. 2 stimulating electrode of the present invention;
Fig. 3 stimulation voltage circuit for generating of the present invention schematic diagram;
The structure chart of Fig. 4 measurement electrode of the present invention;
Fig. 5 injury potential amplifying circuit of the present invention schematic diagram.
The specific embodiment
Below in conjunction with the drawings and specific embodiments, further illustrate the present invention.
Injury potential refers to the DC potential difference existing between injury region and normal place after spinal cord injury, is that normal cell membrane and resting potential are destroyed, injury region Na because spinal cord microenvironment after damage changes
+, Ca
2+etc. a large amount of cationes, flow in born of the same parents, anion flows out and forms.Consequently cause Ca in cell
2+surplus, and then cause a series of biological processes, cause the secondary injury of spinal cord.Therefore in damage, keep afterwards the microenvironment in organism stable, effectively prevent Ca
2+etc. stream in cation, it is the effective means that alleviates degree of injury and improve prognosis.Stop stream in cation to stimulate by extra electric field, the method that changes the direction of ion flow realizes.In addition, injury potential and degree of injury are closely related, damage more seriously, and injury potential initial value is larger, and injury potential, along with the increase of time constantly reduces, becomes logarithmic relationship to decline.This just need to compensate injury potential immediately after damage, and the intensity of electricity irritation also needs to carry out real-time adjustment according to the size of injury potential.
The present invention comprises stimulating electrode, stimulation voltage circuit for generating, injury potential measurement electrode, injury potential amplifying circuit and voltage display device for the electrostimulator of injury potential compensation after spinal cord injury.Spinal cord after the present invention adopts four stimulating electrodes to damage stimulates, and wherein two positive poles are fixed on the muscle of the injury region left and right sides, are close to vertebra; Two other is negative pole, one of them negative pole is fixed near muscle injury region head side vertebra, apart from the distance of two vertebral levels of injury region, another negative pole is fixed near muscle injury region tail side vertebra, is also the distance of two vertebral levels apart from injury region; Stimulating electrode is connected with stimulation voltage circuit for generating, and stimulation voltage circuit for generating can produce adjustable stimulation voltage and be applied on patient's spinal cord to stimulate spinal cord; Three injury potential measurement electrode are attached to respectively on the spinal dura mater of spinal cord injury place, injury region head side and injury region tail side, measure the side injury potential between spinal cord injury place and injury region head side, and the tail side injury potential between spinal cord injury place and injury region tail side; The output of measurement electrode is connected with the input of injury potential amplifying circuit, and voltage display device is connected with the outfan of injury potential amplifying circuit.When implementing electricity irritation, need observe the registration on voltage display device and regulate stimulation voltage, when injury potential is approximately zero, stopping regulating, can realize the compensation of injury potential.
Figure 1 shows that the schematic diagram of injury potential compensation.9 is patient's spinal column, and 6 represent spinal cord injury place, and this place's vertebral plate is opened, and the spinal dura mater of exposing spinal cord injury region.Stimulating electrode 1b and 1c are anodal, are fixed on the two ends, left and right at spinal cord injury place 6, are close to vertebra, stimulating electrode 1a and 1d are negative pole, are placed in respectively a side and the tail side at spinal cord injury place, and wherein electrode 1a is positioned at a side, apart from two vertebral levels of injury region, be fixed near the muscle of vertebra; Electrode 1d is positioned at tail side, apart from two vertebral levels of injury region, is fixed near the muscle of vertebra.Four stimulating electrodes are connected on stimulation voltage circuit for generating 2.7 be injury region head side apart from the spinal cord at 1 vertebral levels place of injury region, this place vertebral plate opened, spinal dura mater exposes; 8 be injury region tail side apart from the spinal cord at 1 vertebral levels place of injury region, this place vertebral plate opened, spinal dura mater exposes.The head of three injury potential measurement electrode 3a, 3b, 3c contacts with the spinal dura mater of 7,6,8 three positions respectively.Three injury potential measurement electrode are connected with injury potential amplifying circuit, and the output voltage of injury potential amplifying circuit shows on voltage display device 5.During use, need adjust according to registration on voltage display device 5 output voltage of stimulation voltage circuit for generating 2, i.e. voltage between stimulating electrode positive pole and negative pole, until the registration on voltage display device 5 is approximately zero.
Fig. 2 is stimulating electrode of the present invention.As shown in Figure 2, stimulating electrode is formed by the coiling on leading screw of thin platinumiridio silk, is solenoid shape, platinumiridio filament diameter is between 0.1～0.3mm, and pitch is between 1～2mm, and the number of turn is 3～5 circles, so can increase the contact area of electrode and organism, reduce the electric current density at electrode place.During constant stimulus electrode, adopt suture through solenoid, stimulating electrode and muscle to be stitched together fixing.The contact conductor of certain length is left in solenoidal one end, for being connected with wire, then receives together stimulation voltage circuit for generating.
Fig. 3 is stimulation voltage circuit for generating schematic diagram of the present invention.As shown in Figure 3, stimulation voltage circuit for generating comprises power supply 10, switch 11, bleeder circuit 12, voltage amplifier circuit 13 and voltage follower circuit 14.Stimulation voltage circuit for generating is powered by power supply 10, and DC source 10 can adopt Switching Power Supply, linear power supply or set of cells, but require power supply can provide " " the positive-negative power voltage equal with absolute value, supply voltage is between 3V and 12V.Such as using two joint 9V batteries series connection, wherein two battery plus-negative plate junctions be defined as circuit " ", thus power supply positive and negative electrode with " " between be respectively+9V of voltage and-9V.In switch 11, comprise two K switch 1 and K2, the first end of K switch 1 and K2 is connected on respectively the positive and negative two ends of power supply, controls closure and the disconnection of positive and negative power supply.In bleeder circuit 12, R1, R3, R4 and R6 are the resistance of resistance 1k Ω, R2 and R5 are the potentiometer of 100 Ω, connect successively in the pin at one end of R1, R2 two ends and one end of R3, the pin at R4 one end, R5 two ends and the series connection of R6 one end, the other end of R1 and R3 is connected respectively to the other end of K1 and K2, and the other end of R4 and R6 is also connected respectively to the other end of K1 and K2.When supply voltage is ± 9V, and K1 and K2 be when closed, bleeder circuit two ends to " " be respectively+9V of voltage and-9V, the output voltage range of R2 and R5 middle pin is between ± 0.43V so.Voltage amplifier circuit 13 adopts two in-phase amplifiers, and one of them consists of U1a, R7 and R8, and another consists of U1b, R9 and R10, and in-phase amplifier has high input impedance and can avoid the voltage in bleeder circuit to calculate and impact; The in-phase input end of U1a and U1b is connected with R5 middle pin with R2 respectively, and U1a and U1b can adopt dual pathways operational amplifier, as LM358; R7 and R8 are respectively the resistance of 1k Ω and the potentiometer of 20k Ω, R7 two ends respectively with the inverting input of U1a with " " be connected, R9 two ends respectively with the inverting input of U1b with " " be connected, R8 two ends are connected with inverting input with the output of U1a respectively, R10 two ends are connected with inverting input with the output of U1b respectively, so can set the amplification of two amplifiers between 1～21 times, output voltage is between ± 0.43V～± 9V.The input of voltage follower circuit 14 is connected with the output of voltage amplifier circuit, can be by voltage amplifier circuit 13 and stimulating electrode isolation, the high input impedance of voltage follower circuit 14 can avoid the impedance between electrode to impact the voltage amplification factor computing formula of voltage amplifier circuit 13, operational amplifier U2a and U2b in voltage follower circuit 14 also can adopt LM358, the in-phase input end of U2a, U2b is connected with the outfan of U1a, U1b respectively, the inverting input of U2a is connected with the outfan of U2a, and the inverting input of U2b is connected with the outfan of U2b.Stimulating electrode 1b, 1c are anodal, with " " be connected, stimulating electrode 1a, 1d are negative pole, are connected respectively with the outfan of U2a, U2b.From above analysis, the positive pole of stimulating electrode and the virtual voltage scope between negative pole are at ± 0.43V～± 9V, but when voltage follower circuit output voltage is between 0～9V, magnitude of voltage is contrary with polarity of electrode definition, this is because reserved the function of reversion polarity of electrode when design, for the expansion of applying from now on provides basis.
Fig. 4 is injury potential measurement electrode of the present invention.Injury potential measurement electrode of the present invention has adopted the structure of salt bridge electrode, electrode cable 15, stopper 23, calomel electrode 16, upper glass pipe 21, interior salt bridge liquid 17, agar 18, lower-glass pipe 22, outer salt bridge liquid 19 and porous ceramics 20, consists of.Upper glass pipe 21 and lower-glass pipe 22 are all upper coarse and lower fine hollow cylindrical, and outer salt bridge liquid is housed in lower-glass pipe 22, and outer salt bridge liquid is normal saline, i.e. the sodium chloride solution 19 of mass percent 0.9%, porous ceramics 20 shutoff for the lower end of lower-glass pipe 22; Inner salt bridge liquid is housed in upper glass pipe 21, interior salt bridge liquid is saturated potassium chloride solution 17, agar 18 shutoff for the lower end of upper glass pipe 21, calomel electrode 16 is placed in upper glass pipe 21, be immersed in saturated potassium chloride solution 17, stopper 23 shutoff for the upper end of upper glass pipe 21, one end of electrode cable 15 is connected with calomel electrode 16, the other end of electrode cable 15 passes from stopper 23, is connected with injury potential amplifying circuit.During use, upper glass pipe is inserted in the outer salt bridge liquid of lower-glass pipe, and two glass tubings are fixed together, one end of porous ceramics 20 shutoff is the head of injury potential measurement electrode.
Fig. 5 is injury potential amplifying circuit schematic diagram of the present invention.Injury potential amplifying circuit comprises differential amplifier circuit 24, reference electrode 25, low-pass filter circuit 26 and voltage follower circuit 27.Differential amplifier circuit, by DC power supply, can adopt Switching Power Supply, linear power supply or battery-powered, but require power supply can provide " " the positive-negative power voltage equal with absolute value, supply voltage is between 3V and 12V.Such as using two joint 9V batteries series connection, wherein two battery plus-negative plate junctions be defined as circuit " ", thus positive and negative electrode with " " between be respectively+9V of voltage and-9V.Differential amplifier circuit 24 consists of two instrument amplifier U3a and U3b, as AD627, R11 and R12 are the resistance of 20k Ω, be connected with U3b with U3a respectively, the amplification of two instrument amplifiers can be set in to 105 times, two instrument amplifiers are used common DC source, and inverting input links together, in addition without other junctions.The measurement electrode 3a that is positioned at spinal dura mater 6 places is connected with the in-phase input end of two instrument amplifiers respectively with the measurement electrode 3c that is positioned at spinal dura mater 8 places, the measurement electrode 3b that is positioned at spinal dura mater 7 places is connected with the inverting input of two instrument amplifiers, and the output of two instrument amplifiers is respectively a side and the tail side injury potential after amplification.In addition, instrument amplifier needs a reference voltage input, and the reference voltage input pin of instrument amplifier is connected with reference electrode 25, and reference electrode 25 need be close to patient skin, and away from measurement electrode, such as the shank of human body.For the High-frequency Interference in filtering injury potential, added low-pass filter circuit 26, this low-pass filter circuit is by resistance R 13 and capacitor C 1, resistance R 14 and capacitor C 2 form, resistance is several ohm to several kilohms, capacitance all can to several microfarads by several pico farads, one end of R13 and R14 is connected with the output of U3a and U3b respectively, the other end is connected with the in-phase input end of two operational amplifiers in voltage follower circuit respectively, also be connected with one end of C1 and C2 respectively, the other end of C1 and C2 all with " " be connected.After low-pass filter circuit, it is voltage follower circuit 27, by two operational amplifier U4a and U4b, formed, the inverting input of U4a and U4b is connected with the output of self respectively, and the high input impedance of voltage follower circuit can avoid the cut-off frequency of low-pass filter circuit to change.Two outputs of voltage follower circuit connect voltage display device 5, a side and tail side injury potential after amplifying can be shown, and this equipment can be circuit tester or oscillograph, also can connect data collecting card measurement data is stored.
The process that use apparatus of the present invention are carried out potential compensation is as follows:
First completely expose the dorsal part of injury region spinal cord, and the spinal cord dorsal part of injury region head side and tail side, the distance between this naked position, three places and injury region is a vertebral levels;
Secondly, constant stimulus electrode, in four stimulating electrodes, two anodal 1b, 1c are fixed on the muscle of the injury region left and right sides, are close to vertebra, and two negative pole utmost point 1a, 1d are fixed on the muscle at injury region head side and two vertebral levels places of tail side;
The 3rd, measure injury potential, three injury potential measurement electrode heads being attached on spinal dura mater gently during measurement; Three injury potential measurement electrode 3a, 3b, 3c lay respectively on injury region, injury region head side and injury region tail side spinal dura mater, three injury potential measurement electrode detect injury potential jointly, wherein between the first injury potential measurement electrode 3a and the second injury potential measurement electrode 3b, voltage is a side injury potential, between the 3rd injury potential measurement electrode 3c and the second injury potential measurement electrode 3b, is tail side injury potential; Observe the registration on voltage display device 5, open two switches of stimulation voltage circuit for generating 2 simultaneously, spinal cord is applied to electricity irritation, and by regulating the resistance of the 3rd potentiometer R8 and the 4th potentiometer R10 in the resistance of the first potentiometer R2 and the second potentiometer R5 in bleeder circuit 12 or voltage amplifier circuit 13, the adjustment of realization to voltage between stimulating electrode, a side after the amplification showing on voltage display device and tail side injury potential are all close to zero time, stop regulating, realize injury potential compensation, thus microenvironment in the body before artificial recovery damage.
Claims (7)
1. for a device for injury potential compensation after spinal cord injury, it is characterized in that: described device comprises four stimulating electrodes (1a, 1b, 1c, 1d), stimulation voltage circuit for generating (2), injury potential measurement electrode (3a, 3b, 3c), injury potential amplifying circuit (4) and voltage display device (5); Described stimulating electrode is connected with stimulation voltage circuit for generating (2), and stimulation voltage circuit for generating (2) produces adjustable stimulation voltage, and by stimulating electrode, stimulation voltage is applied on patient's spinal cord, and spinal cord is stimulated; Described injury potential measurement electrode is connected with the input of injury potential amplifying circuit (4), injury potential amplifying circuit (4) amplifies the injury potential signal of input filtering High-frequency Interference wherein, voltage display device (5) is connected with the outfan of injury potential amplifying circuit (4), for showing the injury potential numerical value after amplification; Described injury potential refers to the DC potential difference existing between injury region and normal place after spinal cord injury; Described device detects injury potential after spinal cord injury by having the injury potential measurement electrode (3a, 3b, 3c) of salt bridge electrode structure, the numerical value of real-time monitored injury potential, the injury potential numerical value obtaining according to observation regulates the size of electricity irritation voltage, make described injury potential close to zero, realize injury potential compensation, thereby keep spinal cord microenvironment relatively stable.
2. according to device claimed in claim 1, it is characterized in that: described stimulating electrode (1a, 1b, 1c, 1d) is made with platinumiridio silk coiling 3～5 circles on leading screw of diameter 0.1～0.3mm, for solenoid shape, pitch is between 1～2mm, stitching thread passes from solenoidal middle part, is stitched together fixing with patient's muscle.
3. according to device claimed in claim 1, it is characterized in that: described stimulation voltage circuit for generating (2) comprises power supply (10), switch (11), bleeder circuit (12), voltage amplifier circuit (13) and voltage follower circuit (14), power supply (10) is DC source, and switch (11) comprises two switches (K1, K2), and one end of one end of the first switch (K1), second switch (K2) is connected on respectively the positive and negative two ends of power supply, in bleeder circuit (12), one end series connection of the two ends of one end of the first resistance (R1), the first potentiometer (R2) and the second resistance (R3), one end series connection of the two ends of one end of the 3rd resistance (R4), the second potentiometer (R5) and the 4th resistance (R6), the other end of the other end of the first resistance (R1) and the second resistance (R3) is connected respectively to the other end of the first switch (K1) and second switch (K2), and the other end of the 3rd resistance (R4) and the 4th resistance (R6) is also connected respectively to the other end of the first switch (K1) and second switch (K2), in voltage amplifier circuit (13), the in-phase input end of operational amplifier U1a and U1b is connected with the second potentiometer (R5) middle pin with the first potentiometer (R2) respectively, the two ends of the 5th resistance (R7) respectively with the inverting input of in-phase amplifier U1a, and " " be connected, the two ends of the 6th resistance (R9) respectively with the inverting input of operational amplifier U1b, and " " be connected, the two ends of the 3rd potentiometer (R8) are connected with inverting input with the output of operational amplifier U1a respectively, the two ends of the 4th potentiometer (R10) are connected with inverting input with the output of operational amplifier U1b respectively, in voltage follower circuit (14), the in-phase input end of operational amplifier U2a and U2b is connected with the outfan of operational amplifier U1a, U1b respectively, the inverting input of operational amplifier U2a is connected with the outfan of self, and the inverting input of operational amplifier U2b is connected with self outfan, two positive poles (1b, 1c) of stimulating electrode with " " be connected, two negative poles (1a, 1d) of stimulating electrode are connected with the outfan of operational amplifier U2a, U2b respectively, by regulating the output voltage of first, second potentiometer (R2, R5) the adjustment bleeder circuit (12) in bleeder circuit (12), adjust the resistance of the 3rd, the 4th potentiometer (R8, R10) in voltage amplifier circuit (13), adjust the amplification of voltage amplifier circuit, signal is amplified.
4. according to device claimed in claim 1, it is characterized in that: described injury potential measurement electrode is comprised of electrode cable (15), stopper (23), calomel electrode (16), upper glass pipe (21), interior salt bridge liquid (17), agar (18), lower-glass pipe (22), outer salt bridge liquid (19) and porous ceramics (20); Upper glass pipe (21) and lower-glass pipe (22) are all upper coarse and lower fine hollow cylindrical; Outer salt bridge liquid (19) is housed, porous ceramics for lower port (20) shutoff of lower-glass pipe (22) in lower-glass pipe (22); Inner salt bridge liquid (17) is housed, agar for lower port (18) shutoff of upper glass pipe (21) in upper glass pipe (21); Calomel electrode (16) is placed in upper glass pipe (21), be immersed in saturated potassium chloride solution (17), stopper for upper end (23) shutoff of upper glass pipe (21), electrode cable (15) one end is connected with calomel electrode (16), the other end passes from stopper (23), is connected with injury potential amplifying circuit; During use, upper glass pipe (21) is inserted in the outer salt bridge liquid (19) of lower-glass pipe (22), and upper glass pipe (21) and lower-glass pipe (22) are fixed together; One end of lower-glass pipe (22) porous ceramics (20) shutoff is the head of injury potential measurement electrode.
5. according to device claimed in claim 4, it is characterized in that: described outer salt bridge liquid (19) is normal saline, the i.e. sodium chloride solution of mass percent 0.9%; Described interior salt bridge liquid (17) is saturated potassium chloride solution.
6. according to device claimed in claim 1, it is characterized in that: described injury potential amplifying circuit (4) consists of differential amplifier circuit (24), reference electrode (25), low-pass filter circuit (26) and voltage follower circuit (27); Differential amplifier circuit (24) consists of two instrument amplifier U3a and U3b, and the inverting input of two instrument amplifier U3a and U3b links together; Injury potential measurement electrode described in two (3a, 3c) is connected with the in-phase input end of described two instrument amplifier U3a and U3b respectively, another injury potential measurement electrode (3b) is connected with the inverting input of two instrument amplifier U3a and U3b, and the output of two instrument amplifier U3a and U3b is connected with the input of low-pass filter circuit (26); The input of voltage follower circuit (27) is connected with the output of low-pass filter circuit (26), and its output is connected to voltage display device (5); Reference electrode (25) is connected with the reference voltage input pin of two instrument amplifier U3a and U3b; The side being recorded by injury potential measurement electrode (3a, 3b, 3c) and tail side injury potential are input to respectively two instrument amplifier U3a and U3b amplifies, afterwards by low-pass filter circuit (26) filter away high frequency noise, then through voltage follower circuit (27), output to voltage display device.
7. according to device claimed in claim 1, it is characterized in that: the process that the device described in using carries out potential compensation is as follows:
First completely expose the dorsal part of injury region spinal cord, and the spinal cord dorsal part of injury region head side and tail side, the distance between this naked position, three places and injury region is a vertebral levels;
Secondly, constant stimulus electrode, in four stimulating electrodes, two positive poles (1b, 1c) are fixed on the muscle of the injury region left and right sides, are close to vertebra, and two negative pole utmost points (1a, 1d) are fixed on the muscle at injury region head side and two vertebral levels places of tail side;
The 3rd, measure injury potential, three injury potential measurement electrode heads being attached on spinal dura mater gently during measurement, three injury potential measurement electrode (3a, 3b, 3c) lay respectively on injury region, injury region head side and injury region tail side spinal dura mater, three injury potential measurement electrode detect injury potential jointly, wherein between the first injury potential measurement electrode (3a) and the second injury potential measurement electrode (3b), voltage is a side injury potential, between the 3rd injury potential measurement electrode (3c) and the second injury potential measurement electrode (3b), is tail side injury potential, observe the registration on voltage display device (5), open two switch (K1 of stimulation voltage circuit for generating (2) simultaneously, K2), spinal cord is applied to electricity irritation, and by regulating the resistance of the 3rd potentiometer (R8) and the 4th potentiometer (R10) in the resistance of the first potentiometer (R2) and the second potentiometer (R5) in bleeder circuit (12) or voltage amplifier circuit (13), the adjustment of realization to voltage between stimulating electrode, a side after the amplification showing on voltage display device and tail side injury potential are all close to zero time, stop regulating, realize injury potential compensation, thereby microenvironment in the body before artificial recovery damage.
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| TWI513484B (en) * | 2013-05-06 | 2015-12-21 | Univ Nat Sun Yat Sen | Multi-channel electronic stimulator for spinal cord stimulation |
| CN106029160B (en) * | 2013-11-01 | 2019-03-15 | 波士顿科学神经调制公司 | For the system in midline delivering subthreshold value treatment |
| CN105030237A (en) * | 2015-07-17 | 2015-11-11 | 中国科学院电工研究所 | Spinal cord injury localization device |
| CN105769169B (en) * | 2016-04-01 | 2018-07-24 | 中国科学院电工研究所 | A kind of spinal cord intrtqoperative care device |
| CN106124564A (en) * | 2016-07-25 | 2016-11-16 | 中国科学院电工研究所 | A kind of exsomatizednerve degree of tissue damage detection device |
| CN107212878A (en) * | 2017-07-11 | 2017-09-29 | 唐佩福 | Spinal cord injury bioelectrical signals conduction device |
| CN113907761B (en) * | 2021-10-09 | 2024-05-07 | 中国人民解放军军事科学院军事医学研究院 | Bipolar implantable myoelectric electrode assembly for stimulation and recording and application method thereof |
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| CN101856221A (en) * | 2010-05-12 | 2010-10-13 | 中国科学院深圳先进技术研究院 | Detection system for determining damage degree and damage positions of spinal cord |
| CN101947357A (en) * | 2010-10-18 | 2011-01-19 | 刘辉 | Device for treating epilepsia |
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