| Abstract: | 軟組織剛性是一種臨床常用的生理數值。客觀的軟組織剛性測量將有利於臨床上疾病的測量與管理。從力學的角度來看，軟組織在受到應力時使軟組織的厚度壓縮，並隨著壓縮過程彈性逐漸增大並逐漸趨近於剛體。本研究認為在不同的需求群體中，對於軟組織剛性的檢測，皆能夠協助其達成更好的健康管理。因此本研究提出了電機驅動超音波壓痕系統，一種可靠的檢測方法，以便達成能穩定檢測軟組織剛性的目的。該系統以步進馬達推進超音波探頭的形式描述軟組織厚度變化，並利用壓力傳感器紀錄計算壓力，以楊氏係數描述軟組織的剛性。具有檢測治療效果的剛性檢測效果的超音波系統。在本研究中，負壓療法對於疤痕的影響用於該設備的臨床檢測中。疤痕是以密封傷口為目的的軟組織，由膠原蛋白和彈性蛋白纖維所構成。通常比正常皮膚更厚、更脆弱，因為疤痕中的膠原蛋白和彈性蛋白纖維更薄、短促且支離破碎。因此疤痕在張力產生時很容易損壞，但疤痕脆弱問題可以通過增加拉伸強度來抵抗。拉伸強度可以表示為粘彈性，而彈性與粘彈性為正比關係。負壓療法被認為可以撫平疤痕並改善粘彈性。這項研究中使用-105、-125 和-145 mmHg三種負壓來比較粘彈性治療前後疤痕和厚度的變化。並使用B型超音波圖像測量疤痕厚度。使用電機驅動超音波壓痕系統的循環力加載測量疤痕粘彈性。在我們的研究中，疤痕厚度在所有三個負壓治療劑量中都顯著減少。與預拔罐相比，-125 mmHg 的劑量顯著增加了足跟區域 (E2) 和線性區域 (E3) 的粘彈性。根據治療前後的比率，-105 mmHg劑量對厚度的影響隨著-125 mmHg (74.5±3.3 vs. 91.3±2.2%，P < 0.001) 和-145 mmHg (74.5±3.3 vs. = 0.010)而增加 )。腳趾區域 (E1) 的粘彈性在 -125 mmHg 劑量與 -145 mmHg 劑量相比顯著降低(184.0 ± 36.0 對 413.7 ± 65.6%，P = 0.019)。正如我們的研究結果所支持的，負壓治療劑量的變化可能是疤痕治療效果的原因。對於劑量調整的結果可以使用電機驅動超音波壓痕系統檢測出差異，本研究將提供一項具有前瞻性的力學生物學紀錄測量方案。
Soft tissue stiffness is a widely utilized clinical physiological parameter with significant implications for disease measurement and management. From a mechanical perspective, the compression of soft tissue under stress leads to an increase in elasticity, gradually approaching a rigid body state. This study proposes the use of a motor-driven ultrasonic indentation system as a reliable method for the objective measurement of soft tissue rigidity, aiming to achieve stable and accurate assessments. The system employs a stepping motor to drive the ultrasonic probe, enabling the measurement of changes in soft tissue thickness, while a pressure sensor records and calculates the corresponding pressure. The rigidity of the soft tissue is described by Young's coefficient. The ultrasonic system possesses robust detection capabilities, which are essential for evaluating treatment effectiveness. In this particular investigation, the impact of negative pressure therapy on scarring was clinically tested using the aforementioned device. Scars, consisting of collagen and elastin fibers, serve to seal wounds, yet they tend to exhibit thinner, shorter, and fragmented fibers, rendering the skin thicker and more vulnerable compared to healthy tissue. Consequently, scars are susceptible to damage when subjected to tension, although this fragility can be mitigated by enhancing tensile strength. Tensile strength can be quantified as viscoelasticity, with elasticity being directly proportional to it. Negative pressure therapy is believed to promote scar smoothing and improve viscoelasticity. In this study, three negative pressure levels (-105, -125, and -145 mmHg) were employed to assess the changes in scar thickness and viscoelasticity before and after the treatment. B-mode ultrasound images were utilized for scar thickness measurements. The motor-driven ultrasonic indentation system facilitated the assessment of scar viscoelasticity through cyclic force loading. The results demonstrated a significant reduction in scar thickness for all three negative pressure doses. Specifically, the dose of -125 mmHg significantly increased viscoelasticity in the heel region (E2) and linear region (E3) compared to pre-cupping. By comparing the ratios before and after treatment, it was observed that the effect of the -105mmHg dose on thickness improvement surpassed that of -125 mmHg (74.5±3.3 vs. 91.3±2.2%, P < 0.001), while the -145mmHg dose exhibited similar effects (74.5±3.3 vs. = 0.010)。 Furthermore, the viscoelasticity of the toe region (E1) was significantly lower for the -125mmHg dose compared to the -145mmHg dose (184.0 ± 36.0 vs. 413.7 ± 65.6%, P = 0.019)。 These findings support the notion that varying the dose of negative pressure therapy plays a role in the treatment outcome for scars, and the motor-driven ultrasonic indentation system proves valuable in detecting such differences. Overall, this study introduces a prospective mechanobiological measurement protocol that offers valuable insights into ultrasound, soft tissue mechanical properties, scar thickness, and scar viscoelasticity. |
