發(fā)布時(shí)間：2018-08-26 20:54

【摘要】：顱內(nèi)壓增高廣泛出現(xiàn)于神經(jīng)外科顱腦疾病患者的臨床綜合征中,嚴(yán)重威脅患者的生命健康。目前臨床上缺乏一種安全有效,實(shí)現(xiàn)顱內(nèi)壓長(zhǎng)時(shí)間床旁無(wú)損精準(zhǔn)監(jiān)測(cè)的技術(shù)。本文利用近紅外技術(shù)組織穿透深度大、安全、易操作等優(yōu)點(diǎn),對(duì)腦水腫引起的顱內(nèi)壓變化開(kāi)展長(zhǎng)時(shí)間、連續(xù)的無(wú)損監(jiān)測(cè)基礎(chǔ)研究。論文的主要工作和創(chuàng)新點(diǎn):1、根據(jù)不同類(lèi)型的腦水腫,構(gòu)建相應(yīng)的腦水腫仿真模型。分別對(duì)單一型腦水腫模型和混合型腦水腫模型進(jìn)行Monte Carlo仿真研究。仿真獲得組織表面光通量和腦水腫程度間的關(guān)系,并確定成人腦組織近紅外檢測(cè)的最佳范圍;2、采用明膠構(gòu)建腦部仿體模型,依據(jù)單一型腦水腫仿真模型改變仿體模型組織參數(shù),并監(jiān)測(cè)仿體表面電壓值。研究發(fā)現(xiàn)仿體表面電壓隨腦水腫程度變化的趨勢(shì)與Monte Carlo仿真結(jié)果一致,驗(yàn)證了Monte Carlo仿真模型的可靠性;3、采用脂多糖試劑制作大鼠腦水腫模型,利用Codman顱內(nèi)壓監(jiān)護(hù)儀和自制組織參數(shù)檢測(cè)系統(tǒng)分別監(jiān)測(cè)大鼠有創(chuàng)顱內(nèi)壓和微創(chuàng)約化散射系數(shù),獲得腦水腫情況下大鼠顱內(nèi)壓與腦組織約化散射系數(shù)的變化規(guī)律,構(gòu)建相應(yīng)的數(shù)學(xué)模型,完成大鼠模型的顱內(nèi)壓近紅外檢測(cè)實(shí)驗(yàn);4、監(jiān)測(cè)神經(jīng)外科術(shù)后監(jiān)護(hù)患者的有創(chuàng)顱內(nèi)壓和無(wú)損腦組織約化散射系數(shù),構(gòu)建約化散射系數(shù)和顱內(nèi)壓的數(shù)學(xué)模型。根據(jù)臨床病人的顱內(nèi)壓精準(zhǔn)測(cè)試結(jié)果完成近紅外無(wú)損顱內(nèi)壓定標(biāo)。研究結(jié)果表明:顱內(nèi)壓的變化規(guī)律和834 nm波長(zhǎng)下約化散射系數(shù)的變化規(guī)律完全吻合,可采用834 nm波長(zhǎng)的近紅外光對(duì)成人腦水腫引起的顱內(nèi)壓變化進(jìn)行有效監(jiān)測(cè)。
[Abstract]:Increased intracranial pressure is widely seen in the clinical syndrome of neurosurgical patients with craniocerebral diseases, which seriously threatens the life and health of patients. At present, there is a lack of a safe and effective technique for accurate monitoring of intracranial pressure near the bed for a long time. Taking advantage of the advantages of deep penetration, safety and easy operation of near-infrared tissue, this paper has carried out a long and continuous nondestructive monitoring of intracranial pressure changes caused by brain edema. The main work and innovation point of this paper is: 1. According to different types of brain edema, the corresponding simulation model of brain edema is constructed. Single brain edema model and mixed brain edema model were simulated by Monte Carlo. The relationship between the luminous flux of tissue surface and the degree of brain edema was obtained by simulation, and the optimum range of near-infrared detection of adult brain tissue was determined. Gelatin was used to construct the model of brain mimic body, and the tissue parameters of the model were changed according to the simulation model of single type of brain edema. The surface voltage of the imitating body was monitored. It was found that the trend of surface voltage change with the degree of brain edema was consistent with that of Monte Carlo simulation. The reliability of Monte Carlo simulation model was verified. The rat brain edema model was made with lipopolysaccharide reagent. Intracranial pressure (ICP) and reduced scattering coefficient of brain tissue in rats were monitored by Codman intracranial pressure monitor and self-made tissue parameter detection system, respectively. The changes of intracranial pressure and reduced scattering coefficient of brain tissue in rats with cerebral edema were obtained. The corresponding mathematical model was constructed, and the experimental work of Intracranial pressure (ICP) near infrared detection in rat model was completed. The invasive intracranial pressure (ICP) and the reduced scattering coefficient of noninvasive brain tissue were monitored after neurosurgery, and the mathematical models of reduced ICP and ICP were constructed. The near infrared nondestructive intracranial pressure calibration was completed according to the accurate test results of intracranial pressure of clinical patients. The results show that the variation of intracranial pressure is in good agreement with that of reduced scattering coefficient at 834 nm wavelength. The change of intracranial pressure caused by brain edema in adults can be effectively monitored by near-infrared light at 834 nm wavelength.
【學(xué)位授予單位】：南京航空航天大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R741.04

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