體外沖擊波疼痛治療系統(tǒng)

1、彈道式?jīng)_擊波疼痛治療系統(tǒng),« STORZ MP 100 »,Radial Shock Wave Therapy,自然界的沖擊波,Thunder and Lightning,,,沖擊波的波形特點,High peak pressureSteep rise Short time durationLow tensile wave components,Pressure,Time,,,,,,P(t),,1980

2、,Electro-hydraulicellipsoid,1985,Piezo-electricsphere,1986,Electro-magneticflat coil/lens,1989,Electro-magneticcylinder coil/paraboloid,,,,傳統(tǒng)的沖擊波發(fā)生方式,,傳統(tǒng)的沖擊波發(fā)生方式ＶＳ彈道式?jīng)_擊波,彈道式?jīng)_擊波,,,V1 = 10 m/s,V2 = 10 m/s,The moving m

3、ass hits a resting mass,Momentum transfer, elastic collision,,彈道式?jīng)_擊波,,,直接的沖擊波造成皮膚的嚴重變形及疼痛,動量傳遞, 軟組織的非彈性碰撞,,彈道式?jīng)_擊波,,,,如何保護皮膚及淺表組織,Momentum transfer, collision via bounce plate,,彈道式?jīng)_擊波,人體,,1. press,2. shoot,,,,,彈道式?jīng)_擊波,人體,,

4、1. press,2. shoot,,,,碰撞速度約 10 m/s,動量轉(zhuǎn)移,活塞,,反彈面,,人體,,,,,彈道式?jīng)_擊波,人體,,,,,,～ 1/r2,淺表效應(yīng),,彈道式?jīng)_擊波,沖擊于固體中傳遞沖擊速度 10 m/s脈沖間期為 5 ms淺表效應(yīng),,彈道式?jīng)_擊波的要點,,,彈道式?jīng)_擊波的效應(yīng),彈道式?jīng)_擊波作用與淺表組織增加受傷組織的循環(huán)及新陳代謝減低疼痛 對分布于淺表組織的神經(jīng)有“轟擊類麻醉”效應(yīng)沖擊波可將大的鈣化轟擊為較

5、小的碎片,利于機體吸收有可能引致體表淤斑,,,,低能沖擊波 (ballistic),,,1-10 bar,,Time,,1-5 ms,Pressure,,Pressure,Time,? 300 ns,100-1000 bar,,高能沖擊波(electro-magnetic),,,,,physical differences,,,高能沖擊波 vs. 低能沖擊波,,(10 000),,(1 / 100),,,Conclusion,,

6、不同的技術(shù),,高能沖擊波,沖擊波壓力: 100-1000bar,,波形間期: 300 ns,,需要精確聚焦,深部組織,能量集中,波形不同,低能沖擊波,1-10 bar,1-5 ms,不需要精確聚焦,較淺組織,能量散射,,,,,,,,MP100 沖擊波疼痛治療系統(tǒng)治療探頭,,,適用于,,,部分適應(yīng)癥,肌腱炎: 如網(wǎng)球肘,高爾夫球肘 肩、肘或膝關(guān)節(jié)的液囊炎癥 頸肩僵硬 跟腱痛 髕骨綜合征 伴有或不伴有骨刺的足底筋

7、膜炎內(nèi)側(cè)脛骨壓力癥 所導(dǎo)致的脛骨疼痛 足跟骨刺 肌筋膜扳機點區(qū)域 骶髂部疼痛,,,禁忌癥,孕婦 起博器使用者 凝血功能障礙 外科手術(shù)后 急性期患者 疼痛超敏患者 腫瘤患者 骨質(zhì)疏松癥 生長期兒童,,,沖擊波VS超聲波,縱向聲波 壓力 : 1.5 bar – 4 bar　　　０bar 穿透深度: 3 cm – 5 cm 8 cm 作用 : 機械

8、 熱效應(yīng)及微循環(huán)效應(yīng)RSWT and US are not in competition, the RSWT is much more stronger than US. We can tell that the RSWT is very usefull where the US become inefficient.,,,應(yīng)用領(lǐng)域,疼痛科 骨科 運動醫(yī)學(xué) 物理康復(fù) 創(chuàng)傷,風(fēng)濕科 脊醫(yī) – Trigger Po

9、ints 針灸科 獸醫(yī),Compétition,The brand nameThe energy levelFeelingKind of applicatorsServiceAfter sales service,,,,,Conclusion,EffectiveSureAvoid surgeryDon‘t need anaesthesiaDon‘t need medical imageryCompac

10、tEasy to use,,,,Conclusion,Non-invasive extracorporeal shock waves therapy (ESWT) is proving to be a successful alternative for specific indications. It is an alternative that is both medically and economically very int