器官保护技术的集中参数模型研究

发布时间：2018-03-26 01:05

本文选题：心脏移植　切入点：器官保护技术　出处：《北京工业大学》2015年硕士论文

【摘要】：心脏移植是终末期心力衰竭最有效的治疗手段。供体心脏的数量是心脏移植的最大制约因素,高质量的心脏保存是提高移植手术成功率和远期生存率的重要环节。目前,常温氧合血不停跳器官保护技术较之于常用的低温冷藏保存法,能大幅度延长心脏体外存活时间,减少对心脏的损伤,但最优的灌注参数与心脏功能的评价指标尚不明确。本论文基于器官保护技术,结合集中参数模型理论,研究离体心脏最优的灌注参数,探讨评价心功能的指标,最后设计离体心脏保存室。首先,建立离体心脏保护模式下的集中参数模型,实现对心脏冠脉系统的灌注,通过改变集中参数变量,确定最优的灌注流量与灌注压力。其次,建立心功能评估模式下的集中参数模型,评估左心功能,探讨主动脉压力、左心室容积以及收缩力/容积函数在心功能中的作用。最后,根据数值研究的基础,综合考虑心脏的生理特点与体外保护时的实际情况,设计了离体心脏保存室,用以保存、运输离体心脏。研究结果表明,第一,建立了离体心脏保护模式的集中参数模型,此模型实现的是对冠脉系统的灌注,最优的灌注压力为45 mm Hg,灌注流量110 ml/min;第二,建立了心功能评估模式的集中参数模型,评估左心的功能,模拟结果显示,当加大后负荷时,主动脉压力升高,左心室的容积变大,收缩力/容积函数降低,均表明了左心的收缩力更大,储血量更高。第三,通过理论研究的基础,设计了离体心脏保存室,其能够提供循环可再利用的血液,保证心脏在水平方向上的平衡,接口的设计可减少对心脏自身血管和瓣膜的损伤。总之,本文为体外保存离体心脏提供灌注保存的场所,并仿真了保护模式下的最优灌注参数以及心功能评估模式下的指标,为衡量体外保护离体心脏的效果提供了有力的参考,为临床上提供更适合、更完善的心脏和移植手术的成功提供有利的保障。
[Abstract]:Heart transplantation is the most effective treatment for end-stage heart failure. The number of donor hearts is the biggest constraint factor for heart transplantation. High quality heart preservation is an important link to improve the success rate and long-term survival rate of transplantation. Compared with the conventional cryopreservation method, oxygenated blood at room temperature can significantly prolong the survival time of the heart in vitro and reduce the damage to the heart. However, the optimal perfusion parameters and the evaluation indexes of cardiac function are not clear. Based on the organ protection technology and the theory of centralized parameter model, the optimal perfusion parameters of isolated heart were studied in this paper, and the evaluation indexes of cardiac function were discussed. At last, the isolated heart preservation chamber is designed. Firstly, the centralized parameter model is established in the isolated heart protection mode to realize the perfusion of the coronary artery system. The optimal perfusion flow rate and perfusion pressure are determined by changing the centralized parameter variables. A centralized parameter model was established to evaluate the left ventricular function, and to investigate the role of aortic pressure, left ventricular volume and contractile force / volume function in cardiac function. Considering the physiological characteristics of the heart and the actual situation of in vitro protection, an isolated heart preservation chamber was designed to preserve and transport the isolated heart. The results show that, first, a centralized parameter model of the isolated heart protection model is established. The optimal perfusion pressure is 45 mm Hgand the perfusion flow rate is 110 ml / min. Secondly, the centralized parameter model of cardiac function evaluation model is established to evaluate the function of the left heart, and the simulation results show that when the afterload is increased, With the increase of aortic pressure, the volume of left ventricle becomes larger, and the contractile force / volume function decreases, which indicates that the left heart has greater contractility and higher blood storage. Thirdly, based on the theoretical research, an isolated heart preservation chamber is designed. It can provide circulating and reused blood, ensure the balance of the heart in the horizontal direction, and the design of the interface can reduce the damage to the heart's own blood vessels and valves. The optimal perfusion parameters in protective mode and the indexes in cardiac function evaluation mode were simulated, which provided a powerful reference for evaluating the effect of protecting isolated heart in vitro and more suitable for clinical application. A better heart and a successful transplant provide a good guarantee.
【学位授予单位】：北京工业大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2

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