本文選題：壓力性尿失禁 + 女性��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:基于盆底MRI及有限元模型分析法,通過對以肛提肌為主的盆底肌在儲(chǔ)、漏尿狀態(tài)幾何與相關(guān)應(yīng)力分析,探討女性中重度壓力性尿失禁(stress urinary inconvenience,SUI)狀態(tài)下盆底肌應(yīng)力分布規(guī)律的研究方法,以期為女性SUI疾病的發(fā)生發(fā)展機(jī)制做進(jìn)一步闡釋,以及后續(xù)盆底修復(fù)治療的技術(shù)改進(jìn)提供新的生物力學(xué)理論基礎(chǔ)。方法:選取就診于我科的女性中重度SUI患者1例,采用3.0T磁共振掃描儀(GE Signal 3.0T磁共振機(jī))對其盆底組織進(jìn)行掃描,采取常規(guī)仰臥位,行橫截位面磁共振掃描,起自膀胱中部,止于陰道外口,層厚2.0mm,收集其盆底MRI薄層數(shù)據(jù),包括骨盆、肛提肌、閉孔內(nèi)肌在內(nèi)的DICOM格式原始數(shù)據(jù),將MRI原始數(shù)據(jù)導(dǎo)入Mimics軟件,應(yīng)用Mimics10.0應(yīng)用軟件對其MRI圖像進(jìn)行三維重建,建立包含肛提肌、閉孔內(nèi)肌及骨盆在內(nèi)的三維幾何模型,并以實(shí)際測得的相應(yīng)尿動(dòng)力結(jié)果(如腹壓、漏尿點(diǎn)壓等)作為必要條件,基于逆向工程的方法,將三維幾何模型導(dǎo)入有限元分析軟件Ansys11.0,初步建立可反映女性中重度SUI狀態(tài)下盆底組織生物力學(xué)分布特征的肛提肌有限元模型,并以有限元方法仿真計(jì)算女性中重度SUI狀態(tài)下儲(chǔ)、漏尿狀態(tài)的應(yīng)力分布。結(jié)果:1.基于逆向工程方法成功建立一可反映女性中重度SUI狀態(tài)下盆底組織應(yīng)力分布的肛提肌有限元模型;2.得到女性中重度SUI患者儲(chǔ)、漏尿狀態(tài)的盆底肌位移及應(yīng)力分布云圖;3.對比分析儲(chǔ)、漏尿狀態(tài)不同腹壓及彈性模量條件下盆底肌應(yīng)力及位移分布的變化。結(jié)論:基于盆底MRI影像數(shù)據(jù)并結(jié)合相應(yīng)的尿動(dòng)力實(shí)測結(jié)果,探討女性中重度壓力性尿失禁(SUI)狀態(tài)下盆底肌的有限元應(yīng)力分析方法,能較為真實(shí)地反映該病理狀態(tài)下盆底組織應(yīng)力變化的分布規(guī)律,有效模擬了中重度SUI儲(chǔ)、漏尿狀態(tài)盆底肌的應(yīng)力、位移變化,可為SUI疾病機(jī)制研究及治療技術(shù)改進(jìn)提供一定的理論參考。
[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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R711.59

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 謝偉;孫峰;;肛提肌損傷與盆底功能障礙性疾病關(guān)系研究[J];局解手術(shù)學(xué)雜志;2016年07期

2 張倩倩;張敬坤;黃向華;;女性壓力性尿失禁研究進(jìn)展[J];實(shí)用婦產(chǎn)科雜志;2016年05期

3 杜薇娜;;女性盆底功能障礙性疾病的研究進(jìn)展[J];中外女性健康研究;2016年02期

4 陳茜;盧媛;堯良清;;有限元分析模型在女性盆底功能障礙性疾病研究中的應(yīng)用及意義[J];國際婦產(chǎn)科學(xué)雜志;2015年04期

5 張皓;堯良清;;有限元法在女性盆底功能障礙性疾病中的應(yīng)用研究進(jìn)展[J];慢性病學(xué)雜志;2015年01期

6 徐浩;張秋林;唐昊;陳博;;腰椎L_3-L_5三維有限元模型的有效性驗(yàn)證[J];中國組織工程研究;2013年35期

7 楊曉紅;王紀(jì)亮;徐惠成;梁志清;;女性盆底有限元力學(xué)分析的研究進(jìn)展[J];局解手術(shù)學(xué)雜志;2013年03期

8 宋紅芳;黃躍;倪成香;雷玲玲;王雪影;劉志成;馬樂;;有限元法仿真計(jì)算多種工況下的肛提肌應(yīng)力[J];中國組織工程研究;2012年26期

9 陳偉;嚴(yán)志漢;吳立軍;;女性盆底肛提肌的有限元分析[J];中國組織工程研究與臨床康復(fù);2010年43期

10 黃薇;胡麗娜;;女性尿失禁治療的循證醫(yī)學(xué)評(píng)價(jià)[J];實(shí)用婦產(chǎn)科雜志;2009年11期

，

本文編號(hào)：1902659