经颅磁(ci)刺激仪的维护与检修探讨(tao)

杨健

福建中医(yi)药大(da)学附属人民医(yi)院设(she)备处，福建福州  350004

【摘(zhai)要】经(jing)颅(lu)磁(ci)刺(ci)激仪在临床上(shang)被广(guang)泛应(ying)用(yong)于脑瘫、抑郁症、癫痫(xian)病、偏头(tou)痛、老年痴(chi)呆(dai)及(ji)精神分裂症等疾(ji)病的诊断(duan)(duan)中(zhong)(zhong)，该(gai)检测方式具(ju)有无(wu)损、无(wu)痛以(yi)及(ji)无(wu)创等特点(dian)，疾(ji)病诊断(duan)(duan)准确(que)率较高(gao)，在广(guang)大患者中(zhong)(zhong)有着较高(gao)的接受(shou)度。当前(qian)，经(jing)颅(lu)磁(ci)刺(ci)激技术在国内(nei)诸多医院中(zhong)(zhong)获(huo)得了日益广(guang)泛的应(ying)用(yong)，但是关于经(jing)颅(lu)磁(ci)刺(ci)激治疗仪器(qi)的维修资料较少。本文就(jiu)经(jing)颅(lu)磁(ci)刺(ci)激治疗仪器(qi)工作原理以(yi)及(ji)故障检修、日常维护等进行总结和探讨以(yi)供同(tong)行进行参考，现综述如下(xia)。

【关键词(ci)】经颅磁刺激仪；维护(hu)；检修

【中图分类号(hao)(hao)】R318.6 【文献标(biao)识码】A 【文章(zhang)编号(hao)(hao)】2096-5249（2021）04-0190-02

经(jing)(jing)颅磁刺(ci)激通过瞬变脉冲磁场穿过颅骨，使大脑皮(pi)质(zhi)(zhi)神(shen)经(jing)(jing)细胞(bao)膜电位获得(de)改(gai)变并(bing)(bing)生成(cheng)电流，从而可对神(shen)经(jing)(jing)电活(huo)动以及脑组织代谢产生影响，对运动皮(pi)质(zhi)(zhi)非(fei)侵(qin)入性刺(ci)激具有无痛、无创以及安全等特点[1-2]。作为常规电生理学(xue)检查方(fang)法(fa)被广(guang)泛用于(yu)皮(pi)质(zhi)(zhi)延髓通路以及皮(pi)质(zhi)(zhi)脊髓通路功能整合的评价中。近(jin)年(nian)来，经(jing)(jing)颅磁刺(ci)激不但(dan)被应用于(yu)大脑皮(pi)质(zhi)(zhi)中，在脑干、神(shen)经(jing)(jing)根等几乎所有传统电刺(ci)激部位均有着广(guang)泛应用[3]。因此，确保经(jing)(jing)颅磁刺(ci)激仪(yi)性能完好并(bing)(bing)能够(gou)正常运转有重要价值。本文(wen)探究经(jing)(jing)颅磁刺(ci)激治(zhi)疗仪(yi)的维护以及检修等相(xiang)关问题进(jin)行如下分(fen)析。

• 经颅磁刺激仪的结构与工作原理

经(jing)(jing)颅(lu)磁(ci)刺激基本(ben)工作原理为在(zai)患者(zhe)头皮特定部位(wei)放置绝(jue)缘线(xian)圈(quan)，对与(yu)线(xian)圈(quan)接通电(dian)(dian)(dian)容器(qi)进行快速关断及导通等方(fang)式，可(ke)使高(gao)强度脉冲电(dian)(dian)(dian)流(liu)于(yu)线(xian)圈(quan)中产(chan)(chan)生(sheng)(sheng)且线(xian)圈(quan)周围可(ke)产(chan)(chan)生(sheng)(sheng)一个短暂有力的(de)(de)脉冲磁(ci)场，穿过皮肤以及软(ruan)组织和颅(lu)骨即可(ke)于(yu)患者(zhe)脑组织中生(sheng)(sheng)成感应电(dian)(dian)(dian)流(liu)，若感应电(dian)(dian)(dian)流(liu)超出神经(jing)(jing)组织兴奋阈(yu)值则可(ke)使得神经(jing)(jing)细胞去(qu)极化，诱发电(dian)(dian)(dian)位(wei)及生(sheng)(sheng)理效应随之产(chan)(chan)生(sheng)(sheng)，既能够引发暂时性的(de)(de)大脑功能抑制和兴奋，同(tong)时也可(ke)引发长(zhang)时程的(de)(de)皮质可(ke)塑性调节[4]。当前，诸多研究及临床应

导(dao)通(tong)，使固态继电器SSR导(dao)通(tong)，大电容(rong)C瞬(shun)时(shi)快速放电和电感L形(xing)成(cheng)LC振(zhen)荡电路，从而产(chan)生强大的时(shi)变磁(ci)场。

经颅磁(ci)刺(ci)(ci)激(ji)(ji)仪(yi)器工(gong)作(zuo)(zuo)电(dian)(dian)(dian)(dian)路模(mo)块(kuai)组成(cheng)(cheng)部分包括(kuo)刺(ci)(ci)激(ji)(ji)线(xian)(xian)圈、主电(dian)(dian)(dian)(dian)源(yuan)模(mo)块(kuai)（主机模(mo)块(kuai)）、软(ruan)件控(kong)制(zhi)(zhi)系统(tong)、人(ren)机交(jiao)互(hu)模(mo)块(kuai)。经颅磁(ci)刺(ci)(ci)激(ji)(ji)仪(yi)的(de)(de)关(guan)键部件为(wei)刺(ci)(ci)激(ji)(ji)线(xian)(xian)圈，主要作(zuo)(zuo)用是发送(song)磁(ci)场，由导电(dian)(dian)(dian)(dian)铜管(guan)线(xian)(xian)、触发按钮、温度传感器、液(ye)体(ti)(ti)散(san)热管(guan)道(dao)等(deng)组成(cheng)(cheng)。根据形(xing)(xing)状(zhuang)差异可(ke)(ke)(ke)分成(cheng)(cheng)锥形(xing)(xing)、帽形(xing)(xing)、圆形(xing)(xing)、椭(tuo)圆形(xing)(xing)、长方形(xing)(xing)、多叶形(xing)(xing)、V字(zi)形(xing)(xing)及8字(zi)形(xing)(xing)等(deng)。在磁(ci)刺(ci)(ci)激(ji)(ji)治疗时线(xian)(xian)圈可(ke)(ke)(ke)产生大量热量，因(yin)此需(xu)要配备冷却(que)模(mo)式(shi)以(yi)使线(xian)(xian)圈温度得到控(kong)制(zhi)(zhi)，冷却(que)模(mo)式(shi)包括(kuo)液(ye)冷、风冷以(yi)及自(zi)然冷却(que)等(deng)。其中，液(ye)冷包括(kuo)线(xian)(xian)圈内冷、外冷以(yi)及油冷和(he)水(shui)冷等(deng)。主电(dian)(dian)(dian)(dian)源(yuan)模(mo)块(kuai)（主机模(mo)块(kuai)）包括(kuo)高(gao)压储(chu)能电(dian)(dian)(dian)(dian)容，可(ke)(ke)(ke)控(kong)硅组件，保险丝(si)， 绝缘(yuan)栅双(shuang)极(ji)型晶体(ti)(ti)管(guan)，主模(mo)块(kuai)控(kong)制(zhi)(zhi)板，水(shui)泥电(dian)(dian)(dian)(dian)阻，状(zhuang)态指示(shi)灯(deng)等(deng)。主要功(gong)能为(wei)高(gao)压储(chu)能电(dian)(dian)(dian)(dian)容充放电(dian)(dian)(dian)(dian)，包括(kuo)电(dian)(dian)(dian)(dian)源(yuan)滤波，功(gong)率因(yin)素调节(jie)，主电(dian)(dian)(dian)(dian)源(yuan)升压，高(gao)压控(kong)制(zhi)(zhi)，液(ye)体(ti)(ti)散(san)热。软(ruan)件控(kong)制(zhi)(zhi)系统(tong)包含病人(ren)信息管(guan)理系统(tong)，可(ke)(ke)(ke)查看病人(ren)的(de)(de)基础信息和(he)就诊信息。主要功(gong)能为(wei)对主机的(de)(de)启(qi)动(dong)自(zi)检，对主机重要部件运行状(zhuang)态的(de)(de)监控(kong)和(he)保护(hu)，自(zi)动(dong)待机。人(ren)机交(jiao)互(hu)模(mo)块(kuai)可(ke)(ke)(ke)显示(shi)仪(yi)器工(gong)作(zuo)(zuo)状(zhuang)态，可(ke)(ke)(ke)对工(gong)作(zuo)(zuo)模(mo)式(shi)，输(shu)出强度、频率，间歇(xie)时间，输(shu)出

图1   经颅磁刺激仪结构 图2   工作电路原理图

用结(jie)果(guo)均表(biao)明，经颅(lu)磁(ci)(ci)刺激(ji)(ji)(ji)治疗(liao)在癫痫(xian)、脑卒中、慢性疼痛(tong)、抑(yi)郁症(zheng)以及(ji)精神分裂症(zheng)、帕金(jin)森病(bing)等多(duo)种病(bing)症(zheng)的(de)(de)治疗(liao)中均有(you)着(zhe)确切的(de)(de)疗(liao)效(xiao)。此外，对于治疗(liao)酒瘾、烟瘾以及(ji)毒瘾等也(ye)有(you)着(zhe)一(yi)定的(de)(de)疗(liao)效(xiao)。经颅(lu)磁(ci)(ci)刺激(ji)(ji)(ji)仪(yi)主要组成部分包(bao)括产生时变磁(ci)(ci)场的(de)(de)刺激(ji)(ji)(ji)线圈以及(ji)产生快速变化电(dian)(dian)流(liu)的(de)(de)主电(dian)(dian)路(lu)。磁(ci)(ci)场以磁(ci)(ci)力线的(de)(de)形式(shi)，无(wu)创伤地透(tou)过皮(pi)肤、颅(lu)骨而刺激(ji)(ji)(ji)到大脑神经[5]（见图1）。而其(qi)工作电(dian)(dian)路(lu)[6]（见图2）主要由变压器T、二极(ji)管组合而成的(de)(de)桥式(shi)整流(liu)电(dian)(dian)路(lu)B、绝缘栅双(shuang)极(ji)型(xing)晶体管

（IGBT共8 个）Q、大电(dian)(dian)(dian)容(rong)C、固态继(ji)电(dian)(dian)(dian)器(qi)SSR、电(dian)(dian)(dian)感L、可(ke)控(kong)硅组(zu)合(he)而成的(de)控(kong)制电(dian)(dian)(dian)路(lu)组(zu)成。外接的(de)交流(liu)市(shi)电(dian)(dian)(dian)首先通(tong)(tong)过变(bian)压器(qi)T的(de)升压，再通(tong)(tong)过桥式整流(liu)电(dian)(dian)(dian)路(lu)B变(bian)成直流(liu)电(dian)(dian)(dian)，然后通(tong)(tong)过绝缘(yuan)栅(zha)双极型晶体管Q的(de)控(kong)制对大电(dian)(dian)(dian)容(rong)C进行(xing)充(chong)(chong)电(dian)(dian)(dian)，充(chong)(chong)电(dian)(dian)(dian)结束后，绝缘(yuan)栅(zha)双极型晶体管Q断开，控(kong)制电(dian)(dian)(dian)路(lu)中的(de)可(ke)控(kong)硅190

时间，刺激序列的编程(cheng)。

• 经颅磁刺激仪的故障检修

• 故障现象及检修情况分析
• 诊断原因：打开磁场刺激仪(依瑞德CCY-Ⅰ型)电源开关，电源灯（黄灯）有亮，打开操作终端软件后启动电源(绿灯）有亮，设备开机正常；打开操作软件运行仪器发现线圈拍无磁场输出，没触发声音并且伴随一股焦糊味。

故(gu)障处(chu)理及分析：磁(ci)场刺激仪的工(gong)作是(shi)由(you)储(chu)能电(dian)(dian)(dian)(dian)(dian)容(rong)(rong)(rong)向刺激线圈快速放电(dian)(dian)(dian)(dian)(dian)生成(cheng)强度＞1.5 T的脉(mai)(mai)冲(chong)磁(ci)场，该(gai)设备可正常开启无触发输出并且内部出现焦糊味为主电(dian)(dian)(dian)(dian)(dian)源(yuan)故(gu)障的表现；设备断电(dian)(dian)(dian)(dian)(dian)打开机箱外壳，从电(dian)(dian)(dian)(dian)(dian)源(yuan)供电(dian)(dian)(dian)(dian)(dian)功率方向一(yi)一(yi)检测(ce)。（1）脉(mai)(mai)冲(chong)电(dian)(dian)(dian)(dian)(dian)源(yuan)（大电(dian)(dian)(dian)(dian)(dian)容(rong)(rong)(rong)）用万用表200 uf档位(wei)，测(ce)量脉(mai)(mai)冲(chong)电(dian)(dian)(dian)(dian)(dian)容(rong)(rong)(rong)容(rong)(rong)(rong)值，标准的脉(mai)(mai)冲(chong)电(dian)(dian)(dian)(dian)(dian)容(rong)(rong)(rong)容(rong)(rong)(rong)值在(zai)140 uf（容(rong)(rong)(rong)量偏

医学食疗与健康   2021 年 2 月第 19 卷第 4 期 ·卫生管理与医学教育·

差±5 %）实(shi)测结果为142.9 uf；（2）检测主(zhu)模块上的32 A 保险(xian)通断，实(shi)测结果为通；（3）观察(cha)20 w1k水(shui)泥(ni)电(dian)阻（两个）发(fa)热(re)情况，发(fa)现(xian)一侧水(shui)泥(ni)电(dian)阻严重发(fa)热(re)，包裹电(dian)阻胶套融化发(fa)出焦(jiao)糊味，用万用表(biao)测阻值(zhi)，水(shui)泥(ni)电(dian)阻未(wei)损坏(huai)；

（4）检(jian)测IGBT（场(chang)管）八个(ge)，用(yong)万用(yong)表测其对应(ying)的引脚是否(fou)有(you)导(dao)(dao)通(tong)，未(wei)(wei)发现损坏情况；（5）检(jian)测pfc模块(kuai)（两个(ge)）， 观察模块(kuai)工(gong)作指示灯(deng)（红灯(deng)）一侧未(wei)(wei)亮起(qi)，标准指示灯(deng)为两灯(deng)常(chang)亮；检(jian)测模块(kuai)保(bao)险通(tong)断，左(zuo)侧10 A，250 V保(bao)险丝不通(tong)。通(tong)过检(jian)测推断为pfc模块(kuai)故障(zhang)导(dao)(dao)致设备运行异常(chang)。

处理方(fang)案及结果：更换pfc模块损坏的(de)10 A，250 V保险丝，开(kai)启设(she)(she)备(bei)后观察该模块工作指(zhi)示灯（红(hong)灯）两个(ge)常(chang)(chang)亮， 空载运行(xing)设(she)(she)备(bei)后线圈拍处输出(chu)正常(chang)(chang)，水泥电阻(zu)未热、无(wu)焦糊(hu)味，设(she)(she)备(bei)运行(xing)正常(chang)(chang)。

• 诊断原因：临床使用过程中仪器自动停机并弹出告警代码（0000100000），该代码为刺激线圈温度警告并且线圈拍有明显发热迹象。

故(gu)(gu)障(zhang)处理及分析：磁场(chang)(chang)刺(ci)(ci)(ci)激(ji)仪(yi)(yi)可以(yi)正(zheng)常启(qi)动(dong)(dong)，线圈拍(pai)(pai)有(you)磁场(chang)(chang)输出刺(ci)(ci)(ci)激(ji)声(sheng)(sheng)音(yin)无异响，仪(yi)(yi)器故(gu)(gu)障(zhang)弹窗报警并自动(dong)(dong)停(ting)机；可以(yi)排(pai)除磁场(chang)(chang)刺(ci)(ci)(ci)激(ji)仪(yi)(yi)主(zhu)模板与控制板故(gu)(gu)障(zhang)，推(tui)断此(ci)次为冷(leng)(leng)(leng)(leng)却(que)(que)系统(tong)故(gu)(gu)障(zhang)，可能(neng)导致(zhi)的原因为：冷(leng)(leng)(leng)(leng)却(que)(que)循环(huan)模块(kuai)故(gu)(gu)障(zhang)，冷(leng)(leng)(leng)(leng)却(que)(que)循环(huan)管(guan)(guan)路破损液(ye)(ye)(ye)(ye)体(ti)泄漏(lou)(lou)，线圈拍(pai)(pai)管(guan)(guan)路堵塞(sai)。（1）仪(yi)(yi)器断电，打开(kai)机箱(xiang)检查(cha)管(guan)(guan)路是(shi)否(fou)破损，仪(yi)(yi)器上是(shi)否(fou)有(you)液(ye)(ye)(ye)(ye)体(ti)遗留痕(hen)迹；（2）将(jiang)刺(ci)(ci)(ci)激(ji)线圈拍(pai)(pai)的波纹管(guan)(guan)逆时(shi)(shi)针旋开(kai)，观(guan)测管(guan)(guan)内(nei)是(shi)否(fou)有(you)异物堵塞(sai)；仪(yi)(yi)器通(tong)电打开(kai)电源开(kai)关启(qi)动(dong)(dong)设备(bei)电源，开(kai)启(qi)仪(yi)(yi)器背后排(pai)液(ye)(ye)(ye)(ye)开(kai)关20秒并查(cha)看冷(leng)(leng)(leng)(leng)却(que)(que)液(ye)(ye)(ye)(ye)是(shi)否(fou)顺利回(hui)流至液(ye)(ye)(ye)(ye)体(ti)存储盒，观(guan)察管(guan)(guan)路是(shi)否(fou)漏(lou)(lou)液(ye)(ye)(ye)(ye)堵塞(sai)；冷(leng)(leng)(leng)(leng)却(que)(que)液(ye)(ye)(ye)(ye)回(hui)到(dao)储存盒且管(guan)(guan)内(nei)无残(can)留说明管(guan)(guan)路无问题；（3）检测冷(leng)(leng)(leng)(leng)却(que)(que)循环(huan)系统(tong)。启(qi)动(dong)(dong)设备(bei)，打开(kai)处方添加降温模式：程序程控刺(ci)(ci)(ci)激(ji)—刺(ci)(ci)(ci)激(ji)强度1 %—刺(ci)(ci)(ci)激(ji)频率(lv)1 HZ—刺(ci)(ci)(ci)激(ji)时(shi)(shi)间1 s—间歇时(shi)(shi)间19 s—运(yun)行时(shi)(shi)间10 min只是(shi)冷(leng)(leng)(leng)(leng)却(que)(que)循环(huan)系统(tong)运(yun)行，刺(ci)(ci)(ci)激(ji)拍(pai)(pai)无声(sheng)(sheng)音(yin)。查(cha)看冷(leng)(leng)(leng)(leng)却(que)(que)系统(tong)是(shi)否(fou)运(yun)作(zuo)，冷(leng)(leng)(leng)(leng)却(que)(que)液(ye)(ye)(ye)(ye)是(shi)否(fou)回(hui)到(dao)线圈拍(pai)(pai)管(guan)(guan)路，若运(yun)行后发(fa)现冷(leng)(leng)(leng)(leng)却(que)(que)液(ye)(ye)(ye)(ye)未回(hui)到(dao)线圈拍(pai)(pai)，冷(leng)(leng)(leng)(leng)却(que)(que)循环(huan)系统(tong)冷(leng)(leng)(leng)(leng)却(que)(que)泵未正(zheng)常启(qi)动(dong)(dong)工作(zuo)。

处理方案(an)及结果：联(lian)系(xi)厂商购(gou)入新泵，更换损坏(huai)部(bu)件后启动仪器进行(xing)(xing)(xing)空载(zai)运(yun)行(xing)(xing)(xing)，线圈拍温度(du)稳定至20～30 ℃， 仪器恢复正常运(yun)行(xing)(xing)(xing)。

3 经(jing)颅磁刺激仪日常维护

（1）应用(yong)含有异丙醇(chun)或者(zhe)(zhe)中性(xing)清(qing)(qing)洁剂的抹(mo)布定(ding)期对(dui)仪(yi)器(qi)(qi)(qi)与(yu)配件(jian)(jian)表面(mian)进行(xing)清(qing)(qing)洁及(ji)消(xiao)毒，注(zhu)意不可对(dui)刺(ci)(ci)激线圈(quan)实施(shi)高压(ya)、高温消(xiao)毒，同时应避免体(ti)液污染刺(ci)(ci)激线圈(quan)[7]；（2）在(zai)(zai)(zai)用(yong)经颅磁刺(ci)(ci)激仪(yi)前必须(xu)确保证连接(jie)(jie)(jie)线缆接(jie)(jie)(jie)口(kou)牢固且刺(ci)(ci)激线圈(quan)完全(quan)干(gan)燥，检(jian)查(cha)仪(yi)器(qi)(qi)(qi)各(ge)个部(bu)件(jian)(jian)，特别(bie)是线圈(quan)线缆接(jie)(jie)(jie)口(kou)是否存在(zai)(zai)(zai)腐蚀或者(zhe)(zhe)破损等迹象。在(zai)(zai)(zai)高压(ya)状(zhuang)态(tai)下长(zhang)时间(jian)连续工(gong)(gong)作(zuo)容易(yi)导致电击腐蚀，一旦发现(xian)(xian)(xian)此(ci)类异常现(xian)(xian)(xian)象需要立即(ji)停用(yong)仪(yi)器(qi)(qi)(qi)并在(zai)(zai)(zai)对(dui)受损部(bu)件(jian)(jian)进行(xing)更换或者(zhe)(zhe)修(xiu)(xiu)复(fu)后方可再次使用(yong)仪(yi)器(qi)(qi)(qi)，以免仪(yi)器(qi)(qi)(qi)损坏或者(zhe)(zhe)诱发医(yi)疗事故[8]；（3）治(zhi)疗过程中对(dui)刺(ci)(ci)激线圈(quan)工(gong)(gong)作(zuo)温度(du)出(chu)现(xian)(xian)(xian)过高等现(xian)(xian)(xian)象加强关注(zhu)，患者(zhe)(zhe)治(zhi)疗间(jian)隙应确保刺(ci)(ci)激线圈(quan)冷却(que)时间(jian)充足，防止长(zhang)时间(jian)刺(ci)(ci)激线圈(quan)在(zai)(zai)(zai)过热(re)状(zhuang)态(tai)下工(gong)(gong)作(zuo)而受损；（4）定(ding)期进行(xing)仪(yi)器(qi)(qi)(qi)各(ge)个部(bu)件(jian)(jian)检(jian)修(xiu)(xiu)，明确冷却(que)出(chu)风(feng)口(kou)是否出(chu)现(xian)(xian)(xian)堵(du)塞等现(xian)(xian)(xian)象，及(ji)时将堵(du)塞异物及(ji)灰(hui)尘清(qing)(qing)理干(gan)净(jing)；（5）确保仪(yi)器(qi)(qi)(qi)设备在(zai)(zai)(zai)良好的环(huan)境(jing)下工(gong)(gong)作(zuo)，环(huan)境(jing)湿度(du)保持33～75 %，温度(du)5～35 ℃，确保仪(yi)器(qi)(qi)(qi)设备所处(chu)环(huan)境(jing)无易(yi)燃、易(yi)爆(bao)气体(ti)，无腐蚀性(xing)及(ji)粉尘[9]。

4 结语

经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)技术乃医学及电磁学结合的(de)(de)典(dian)范，刺(ci)(ci)(ci)激(ji)(ji)模式包括双脉冲(chong)(chong)经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)、单脉冲(chong)(chong)经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)以及重(zhong)复性经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)。第一台经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)治(zhi)疗仪(yi)(yi)于(yu)1985年由Barker等研(yan)发(fa)而(er)成，受技术条件的(de)(de)限(xian)制，该(gai)治(zhi)疗仪(yi)(yi)仅能够进行单脉冲(chong)(chong)冲(chong)(chong)击治(zhi)疗。近年来，脉冲(chong)(chong)宽度可调控经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)仪(yi)(yi)器在(zai)临床上应用日益广泛，并(bing)将(jiang)经(jing)(jing)(jing)(jing)颅(lu)磁刺(ci)(ci)(ci)激(ji)(ji)仪(yi)(yi)的(de)(de)研(yan)制与(yu)开发(fa)推(tui)向(xiang)了新的(de)(de)阶段。

经颅磁(ci)(ci)刺(ci)激技(ji)术(shu)属于(yu)能(neng)(neng)量(liang)转(zhuan)换技(ji)术(shu)。工作过(guo)程(cheng)中，经颅磁(ci)(ci)刺(ci)激治(zhi)疗仪将电(dian)(dian)能(neng)(neng)转(zhuan)化为(wei)磁(ci)(ci)能(neng)(neng)后(hou)再将磁(ci)(ci)能(neng)(neng)转(zhuan)化为(wei)电(dian)(dian)能(neng)(neng)， 能(neng)(neng)量(liang)相互转(zhuan)化过(guo)程(cheng)中涉及(ji)(ji)刺(ci)激线(xian)圈、能(neng)(neng)量(liang)释放电(dian)(dian)路以及(ji)(ji)储(chu)能(neng)(neng)电(dian)(dian)容等多个(ge)关键(jian)部(bu)分。随着医(yi)(yi)(yi)学水平的(de)不(bu)(bu)断发展，医(yi)(yi)(yi)疗设备不(bu)(bu)断更(geng)新换代(dai)的(de)同时，精密程(cheng)度和(he)集(ji)成程(cheng)度越来越高，也会产(chan)生各(ge)种各(ge)样的(de)故(gu)障，不(bu)(bu)但影响医(yi)(yi)(yi)院的(de)经济效(xiao)益和(he)社(she)会效(xiao)益，甚至可能(neng)(neng)产(chan)生医(yi)(yi)(yi)疗事故(gu)。

由于(yu)经颅(lu)磁刺(ci)激治(zhi)疗仪(yi)等医疗设(she)备具(ju)有(you)电路(lu)板(ban)结构复(fu)杂以及(ji)(ji)集成度(du)高等特(te)点，生(sheng)产商通常(chang)不向用户提供详细的(de)(de)维修(xiu)技术资(zi)料，一旦(dan)仪(yi)器(qi)设(she)备出(chu)现故(gu)(gu)障(zhang)(zhang)，医院(yuan)通常(chang)面临较高的(de)(de)维修(xiu)难(nan)度(du)。医院(yuan)医疗器(qi)械工程(cheng)师(shi)需通过(guo)各(ge)种有(you)效的(de)(de)信息途径掌握仪(yi)器(qi)维修(xiu)的(de)(de)相(xiang)关信息和(he)资(zi)料，熟(shu)练掌握仪(yi)器(qi)设(she)备的(de)(de)工作原理，然后对(dui)发生(sheng)故(gu)(gu)障(zhang)(zhang)的(de)(de)具(ju)体(ti)部(bu)件进(jin)行(xing)(xing)排查和(he)分析(xi)，及(ji)(ji)时检出(chu)故(gu)(gu)障(zhang)(zhang)发生(sheng)原因。在进(jin)行(xing)(xing)故(gu)(gu)障(zhang)(zhang)排查过(guo)程(cheng)中必须对(dui)高压是否泄放(fang)等做出(chu)准(zhun)确判(pan)(pan)断以保证维修(xiu)过(guo)程(cheng)的(de)(de)安全性。同(tong)时还可(ke)(ke)(ke)尝试参考仪(yi)器(qi)故(gu)(gu)障(zhang)(zhang)部(bu)件电路(lu)板(ban)画出(chu)线路(lu)图，有(you)助于(yu)器(qi)械工程(cheng)师(shi)对(dui)故(gu)(gu)障(zhang)(zhang)点做出(chu)准(zhun)确而清晰的(de)(de)判(pan)(pan)断，及(ji)(ji)时联(lian)系厂商更换(huan)特(te)殊定(ding)制(zhi)的(de)(de)配件，替换(huan)修(xiu)复(fu)受损通用集成电路(lu)模块或者普通元(yuan)件，尽可(ke)(ke)(ke)能排除各(ge)类可(ke)(ke)(ke)能导致仪(yi)器(qi)设(she)备发生(sheng)故(gu)(gu)障(zhang)(zhang)的(de)(de)相(xiang)关因素，确保仪(yi)器(qi)设(she)备及(ji)(ji)早恢(hui)复(fu)正常(chang)运行(xing)(xing)，为更多脑功能障(zhang)(zhang)碍患者提供有(you)效的(de)(de)治(zhi)疗干预措施，促(cu)进(jin)其(qi)病情及(ji)(ji)预后改善[10]。

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