漏斗胸与脊柱侧弯同时矫形对胸廓变形影响的数值模拟

发布时间：2018-03-11 09:05

本文选题：漏斗胸　切入点：脊柱侧凸　出处：《中国组织工程研究》2017年19期 　论文类型：期刊论文

【摘要】：背景:目前对于漏斗胸微创矫形在生物力学方面的研究已经取得了一些进展,但还缺少脊柱侧弯矫形对漏斗胸胸廓变形的影响,没有脊柱侧弯与漏斗胸同时矫形方面的研究工作。目的:探索漏斗胸与脊柱侧弯同时矫形对畸形胸廓变形的影响,为临床矫形手术方案设计提供参考。方法:采用三维重建方法,利用漏斗胸合并脊柱侧弯病例的CT图片,重建漏斗胸合并脊柱侧弯的胸廓实体模型,采用数值模拟方法模拟对漏斗胸微创矫形和脊柱侧弯拉伸矫形同时矫形的过程。结果与结论:(1)从漏斗胸和脊柱侧弯同时矫形后再卸载的数值结果来看,T3-T5节胸椎两侧的横突有向左(X方向)移动1 mm左右,这说明漏斗胸和脊柱侧弯同时矫形对脊柱侧弯有一定的帮助;(2)通过对比漏斗胸和脊柱侧弯同时矫形与单纯漏斗胸矫形的数值结果可以看出,胸骨柄的最小位移差别明显,同时矫形再卸载脊柱拉伸矫形胸在Y方向上比单纯进行漏斗胸矫形的位移大13.358 mm,说明采用同时矫形再卸载脊柱拉伸矫形对漏斗胸畸形改善有利;(3)在等效应力分布上,同时矫形后胸骨受到的最大应力比单纯进行漏斗胸矫形应力降低24.6 MPa,说明同时矫形后再卸载脊柱拉伸矫形载荷能够显著降低胸廓的等效应力,有助于减轻患者的术后胸廓疼痛问题;(4)结果提示,漏斗形和脊柱侧弯同时矫形不仅对脊柱侧弯改善有利,对漏斗胸病症也有改善作用。
[Abstract]:Background: some progress has been made in the biomechanical study of funnel chest minimally invasive orthotics, but there is no effect of scoliosis on pectoral deformation. No simultaneous correction of scoliosis and funnel chest. Objective: to investigate the effect of simultaneous correction of pectoralis funnelis and scoliosis on deformity of thorax. Methods: three dimensional reconstruction method was used to reconstruct thoracic solid model of funnel chest combined with scoliosis by using CT images of patients with funnel chest combined with scoliosis. A numerical simulation method was used to simulate the simultaneous correction of minimally invasive correction of funnel chest and extension of scoliosis. Results and conclusions 1) from the numerical results of simultaneous correction of funnel chest and scoliosis before unloading, we can see that there are two thoracic vertebrae in T3-T5. The lateral transverse process moved about 1 mm to the left X direction. This shows that the simultaneous correction of funnel chest and scoliosis is helpful to scoliosis to some extent. By comparing the numerical results of the correction of funnel chest and scoliosis simultaneously with that of pure pectus excavatum, we can see that the minimum displacement of sternum stalk is obviously different. At the same time, the displacement in Y direction was 13.358 mm larger than that in simple funnel chest orthopedic orthopedic reloading, which indicated that using simultaneous orthopedic and reunloading spinal tension orthosis could improve the deformity of funnel chest and improve the distribution of equivalent stress. At the same time, the maximum stress of sternum after orthopedic treatment was 24.6 MPa lower than that of pure orthopedic orthopedic stress of funnel chest, which indicated that the tensile orthopedic load of spine after orthopedic correction could significantly reduce the equivalent stress of thorax. The results suggest that the correction of funnel shape and scoliosis at the same time is not only beneficial to the improvement of scoliosis, but also to the disease of funnel chest.
【作者单位】：天津理工大学机械工程学院天津市先进机电系统设计与智能控制重点实验室;解放军北京军区总医院胸外科;
【基金】：国家自然科学基金(11372221)~~
【分类号】：R687.3

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