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Uvod: Med najpomembnejšimi stanji z osnovno nevrološko komponento, ki poslabša srčno-žilno disfunkcijo, je tudi bolezen koronarnih arterij. Zunanji sluhovod je oživčen z avrikularno vejo živca vagusa, preko katere je mogoče dražiti njegovo senzorično nitje. Z draženjem le-tega pri bolnikih s koronarno boleznijo lahko vplivamo na vitalne funkcije. Metodo draženja, ki se izvaja preko elektrode, vstavljene v zunanji del sluhovoda, imenujemo transkutana električna stimulacija avrikularnega živca. Namen: Merjenje učinkov transkutanega draženja izbranih mest zunanjega sluhovoda, kjer se nahajajo končiči avrikularne veje ŽV, na dihanje, toplotno in srčno funkcijo. Cilj diplomskega dela je bil vzpostaviti protokol za zagotovitev varne in ponovljive selektivne stimulacije zunanjega sluhovoda. Metode dela: Preiskovanec je bil moški s potrjeno koronarno arterijsko boleznijo, ki smo ga pripravili na meritev v skladu z vzpostavljenim protokolom, nato pa na njem izvedli selektivno transkutano električno stimulacijo avrikularnega živca. Za draženje vlaken ŽV smo uporabili prototip naprave transkutane električne stimulacije avrikularnega živca. Merilne komponente, ki smo jih uporabili, so termistor, sistem za merjenje pretoka zraka, pulzni oksimeter in merilec krvnega tlaka. Meritve dihalne, toplotne in srčne funkcije smo izvedli pred stimulacijo ter med njo in po njej. Rezultati: Za izboljšanje dihalne funkcije nam je pretok zraka v najboljšem primeru uspelo povečati za 1,6 l/min, frekvenco dihanja smo pospešili za 2 min-1, vsebnost kisika v krvi pa smo povečali za 1,7 %. Za izboljšanje toplotne funkcije nam je telesno temperaturo uspelo znižati največ za 0,2 °C. Za izboljšanje srčne funkcije smo frekvenco srčnega utripa upočasnili za 2,5 min-1, sistolični arterijski krvni tlak smo zmanjšali za 9 mmHg, diastolični arterijski krvni tlak pa za 5 mmHg. Razprava in zaključek: Stimulirano mesto ima pomembno vlogo pri selektivni transkutani stimulaciji, saj so od njega odvisni učinki na dihalno, toplotno in srčno funkcijo. Ugotovili smo, da je s transkutano stimulacijo avrikularnega živca mogoče vplivati na dihalno, toplotno in srčno funkcijo, vendar je za velikost učinka pomembna mikrolokacija draženja. Introduction: Among the most important conditions with a basic neurological component that exacerbates cardiovascular dysfunction is also coronary artery disease. The cymba conchae (external ear) is innervated by the auricular branch of the NV, through which its sensory threads can be stimulated. By stimulating it in patients with coronary heart disease, vital functions can be affected. The method of stimulation, which is performed through an electrode inserted into external ear, is called transcutaneous electrical stimulation of the auricular nerve. Purpose: Measurement of the effects of transcutaneous stimulation of selected sites of the external ear, where the tips of the auricular branch of the NV are located, on respiratory, thermal and cardiac function. The aim of the diploma work was to establish a protocol to ensure safe and reproducible selective stimulation of the external ear. Methods: The subject was an adult man with confirmed coronary artery disease, who was prepared for measurement according to the established protocol. The stimulation of the auricular nerve was performed on him. A prototype device of transcutaneous elektrical stimulation of the auricular nerve was used to stimulate the NV fibers. The measuring components used were a thermistor, air flow measurement system, pulse oximeter, and blood pressure monitor. Measurements of respiratory, thermal, and cardiac function were performed before, during, and after stimulation. Results: To improve respiratory function, we were able to increase air flow by 1.6 l / min, respiration rate was accelerated by 2 min-1, and SpO2 was increased by 1.7%. To improve the thermal function, we managed to lower body temperature by 0.2°C. To improve cardiac function, heart rate was slowed by 2.5 min-1, systolic blood pressure was reduced by 9 mmHg, and diastolic blood pressure was reduced by 5 mmHg. Discussion and conclusion: The measured effects on the vital functions depend on the stimulated site of the external ear, thus these sites play a pivotal role in the application of selective transcutaneous stimulation. We found that respiratory, thermal, and cardiac function can be affected by transcutaneous stimulation of the auricular nerve, however the microlocation of the stimulation is important for the magnitude of the effect. |
