改良B-T手术不同搭桥方式的血流动力学比较

发布时间：2018-05-01 05:11

本文选题：血流动力学 + 计算流体动力学　；参考：《医用生物力学》2014年02期

【摘要】：目的通过数值模拟的方法对比分析端对边(end-to-side,ETS)与边对边(side-to-side,STS)两种不同搭桥方式的改良B-T手术(modified blalock-taussig shunt,MBTS)对血流动力学的影响,为临床治疗单心室心脏缺陷综合征提供参考。方法采集单心室心脏缺陷综合征病人的医学图像,重建病人心脏真实的几何模型;基于虚拟手术操作系统模拟手术过程;采集病人的生理数据,建立病人的集中参数模型(lumped parameter model,LPM);通过LPM计算提供计算流体力学(computational fluid dynamics,CFD)仿真模型的近生理边界条件;利用有限体积法对模型进行数值仿真。结果分别获取了ETS模型和STS模型的血液流速以及壁面切应力分布。ETS模型和STS模型的吻合口部位振荡剪切系数(oscillatory shear index,OSI)分别为3.058×10-3和13.624×10-3,能量损失分别为116.5和94.8 mW,右、左肺动脉流量比RRPA/LPA分别为0.8和1.72。结论两个模型的能量损失相差不大,对手术的影响相对较小。STS搭桥方式左右肺动脉流量分布均匀,吻合口位置OSI值较小,优于ETS搭桥方式,应着重考虑。本研究为临床治疗单心室心脏缺陷综合征提供重要的理论支持和参考。
[Abstract]:Objective to compare and analyze the hemodynamic effects of modified B-T operation (modified blalock-taussig shuntmb TS) on hemodynamics of end-to-side ETSs and side-to-sideside STSs by means of numerical simulation, and to provide a reference for clinical treatment of single-ventricular heart defect syndrome. Methods the medical images of patients with single ventricular heart defect syndrome were collected to reconstruct the real geometric model of the patients' heart, the operation process was simulated based on the virtual operation system, and the physiological data of the patients were collected. The lumped parameter model is established, and the near physiological boundary conditions of computational fluid dynamics (CFDs) simulation model are provided by LPM calculation, and the finite volume method is used to simulate the model. Results the blood velocity and wall shear stress distribution of ETS model and STS model were obtained. The oscillatory shear coefficients of anastomotic site of STS model and STS model were 3.058 脳 10 ~ (-3) and 13.624 脳 10 ~ (-3), respectively, and the energy loss were 116.5 and 94.8 MW, right, respectively. The left pulmonary artery flow ratio (RRPA/LPA) was 0. 8 and 1. 72, respectively. Conclusion there is no significant difference in energy loss between the two models. The influence on the operation is relatively small. The distribution of left and right pulmonary artery flow is uniform and the OSI value of anastomotic site is smaller, which is better than that of ETS bypass. This study provides important theoretical support and reference for clinical treatment of single ventricular heart deficiency syndrome.
【作者单位】：北京工业大学生物医学工程中心;首都医科大学附属安贞医院;
【基金】：国家自然科学基金资助项目(11172016) 高等学校博士学科点专项科研基金资助课题(20111103110012) 北京市自然科学基金重点项目(KZ20120005006)
【分类号】：R318.01

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