女性中重度压力性尿失禁患者盆底肌的有限元建模及储、漏尿状态仿真应力分析

发布时间：2018-05-17 19:59

本文选题：压力性尿失禁 + 女性　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:基于盆底MRI及有限元模型分析法,通过对以肛提肌为主的盆底肌在储、漏尿状态几何与相关应力分析,探讨女性中重度压力性尿失禁(stress urinary inconvenience,SUI)状态下盆底肌应力分布规律的研究方法,以期为女性SUI疾病的发生发展机制做进一步阐释,以及后续盆底修复治疗的技术改进提供新的生物力学理论基础。方法:选取就诊于我科的女性中重度SUI患者1例,采用3.0T磁共振扫描仪(GE Signal 3.0T磁共振机)对其盆底组织进行扫描,采取常规仰卧位,行横截位面磁共振扫描,起自膀胱中部,止于阴道外口,层厚2.0mm,收集其盆底MRI薄层数据,包括骨盆、肛提肌、闭孔内肌在内的DICOM格式原始数据,将MRI原始数据导入Mimics软件,应用Mimics10.0应用软件对其MRI图像进行三维重建,建立包含肛提肌、闭孔内肌及骨盆在内的三维几何模型,并以实际测得的相应尿动力结果(如腹压、漏尿点压等)作为必要条件,基于逆向工程的方法,将三维几何模型导入有限元分析软件Ansys11.0,初步建立可反映女性中重度SUI状态下盆底组织生物力学分布特征的肛提肌有限元模型,并以有限元方法仿真计算女性中重度SUI状态下储、漏尿状态的应力分布。结果:1.基于逆向工程方法成功建立一可反映女性中重度SUI状态下盆底组织应力分布的肛提肌有限元模型;2.得到女性中重度SUI患者储、漏尿状态的盆底肌位移及应力分布云图;3.对比分析储、漏尿状态不同腹压及弹性模量条件下盆底肌应力及位移分布的变化。结论:基于盆底MRI影像数据并结合相应的尿动力实测结果,探讨女性中重度压力性尿失禁(SUI)状态下盆底肌的有限元应力分析方法,能较为真实地反映该病理状态下盆底组织应力变化的分布规律,有效模拟了中重度SUI储、漏尿状态盆底肌的应力、位移变化,可为SUI疾病机制研究及治疗技术改进提供一定的理论参考。
[Abstract]:Objective: based on pelvic floor MRI and finite element model analysis, the geometry and relative stress of pelvic floor muscle were analyzed. To study the stress distribution of pelvic floor muscle in female patients with moderate and severe stress urinary incontinence (urinary incontinence sui) in order to further explain the mechanism of occurrence and development of female SUI disease. And to provide a new biomechanical theoretical basis for the technical improvement of pelvic floor repair therapy. Methods: the pelvic floor tissue was scanned by 3.0T magnetic resonance scanner (GE Signal 3.0T magnetic resonance machine) in a female patient with moderate and severe SUI. The pelvic floor tissue was scanned by conventional supine position and transversal magnetic resonance imaging (MRI) from the middle of the bladder. The MRI thin layer data of pelvic floor, including pelvic, levator ani and obturator muscles, were collected from the vaginal orifice with a thickness of 2.0 mm. The original MRI data were imported into the Mimics software, and the MRI images were reconstructed by Mimics10.0 software. A three-dimensional geometric model including levator ani muscle, obturator muscle and pelvis was established, and the corresponding urodynamic results (such as abdominal pressure, leakage point pressure, etc.) were taken as necessary conditions and based on reverse engineering method. The 3D geometric model was introduced into finite element analysis software ANSYS 11.0. the finite element model of levator ani muscle was established to reflect the biomechanical distribution of pelvic floor tissue in female patients with moderate and severe SUI, and the storage of levator ani muscle under moderate and severe SUI state was simulated by finite element method. Stress distribution of urine leakage state. The result is 1: 1. Based on reverse engineering method, a finite element model of levator ani muscle was successfully established to reflect the stress distribution of pelvic floor tissue in women with moderate and severe SUI. The pelvic floor muscle displacement and stress distribution of female patients with moderate and severe SUI were obtained. The stress and displacement distribution of pelvic floor muscle under different abdominal pressure and elastic modulus were analyzed. Conclusion: based on the data of pelvic floor MRI and the corresponding results of urodynamic measurement, the finite element stress analysis method of pelvic floor muscles in women with moderate and severe stress incontinence (sui) is discussed. It can truly reflect the stress distribution of pelvic floor tissue under the pathological condition, and can effectively simulate the stress and displacement changes of pelvic floor muscle in the condition of moderate and severe SUI storage and urine leakage. It can provide some theoretical reference for the study of SUI disease mechanism and the improvement of treatment technology.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.59

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