本文選題：前庭半規(guī)管 + 橢圓囊內(nèi)淋巴閥��； 參考：《大連理工大學(xué)》2013年博士論文

【摘要】：人內(nèi)耳前庭系統(tǒng)在維持身體平衡中起著先導(dǎo)作用。但是由于內(nèi)耳埋藏位置深,結(jié)構(gòu)復(fù)雜而精細(xì),導(dǎo)致前庭常見疾病的病因和發(fā)病機(jī)制尚需明確,前庭功能檢查定側(cè)和定位上的診斷還缺乏有效手段,前庭疾病的治療多限于對(duì)癥。前庭系統(tǒng)功能異常和病理變化以及過(guò)度的外界環(huán)境激勵(lì)是誘發(fā)眩暈的重要原因,嚴(yán)重影響了人們的生活質(zhì)量。對(duì)于飛行員等特殊職業(yè)人員眩暈是導(dǎo)致飛行事故的重要因素。生物力學(xué)因素在內(nèi)耳前庭系統(tǒng)行使平衡功能的過(guò)程中起著重要作用,其中前庭半規(guī)管感受頭位有角運(yùn)動(dòng)依賴于管中內(nèi)淋巴液的流動(dòng)和嵴頂形變之問的相互作用和一個(gè)機(jī)電傳導(dǎo)過(guò)程。將力學(xué)的基本原理與方法應(yīng)用于人內(nèi)耳前庭系統(tǒng)結(jié)構(gòu)與平衡機(jī)制的相關(guān)性研究,可為探討眩暈病癥與內(nèi)耳結(jié)構(gòu)的相關(guān)性,提高前庭功能檢查定側(cè)、定位診斷敏感性,尋找有效治療方法等提供定量依據(jù)。本文主要工作包括： 1、通過(guò)對(duì)豚鼠內(nèi)耳結(jié)構(gòu)的研究,獲得豚鼠內(nèi)耳結(jié)構(gòu)三維重建的有效方法。在此基礎(chǔ)上,根據(jù)一例正常人內(nèi)耳前庭半規(guī)管結(jié)構(gòu)的數(shù)據(jù),對(duì)其幾何結(jié)構(gòu)進(jìn)行三維重建。采用有限元法對(duì)該半規(guī)管內(nèi)淋巴液——嵴頂耦合系統(tǒng)進(jìn)行了模態(tài)分析,得到系統(tǒng)的基頻為13.46Hz,遠(yuǎn)高于人日常自然活動(dòng)頻率以及臨床旋轉(zhuǎn)試驗(yàn)和冷熱試驗(yàn)的檢查頻率。 2、進(jìn)行了體位變化激勵(lì)下人雙耳前庭半規(guī)管平衡機(jī)制的數(shù)值分析。結(jié)果表明,頭繞對(duì)稱軸水平正弦轉(zhuǎn)動(dòng)或左右正弦滾轉(zhuǎn)時(shí),左右耳對(duì)稱半規(guī)管的力學(xué)響應(yīng)幅值相等,相位相差3.14rad,使得對(duì)稱半規(guī)管的刺激強(qiáng)弱相反：頭前后正弦翻轉(zhuǎn)時(shí),雙耳對(duì)稱半規(guī)管的力學(xué)響應(yīng)幅值和相位均相等,使得對(duì)稱半規(guī)管的刺激強(qiáng)弱相同。由此推斷任意頭位變化,通過(guò)前庭眼反射,雙耳前庭半規(guī)管中的力學(xué)響應(yīng)將誘發(fā)雙眼向相同的方向等幅度轉(zhuǎn)動(dòng),維持視網(wǎng)膜成像的穩(wěn)定。 3、對(duì)健康人雙耳前庭半規(guī)管在人自然活動(dòng)頻率范圍頭水平轉(zhuǎn)動(dòng)進(jìn)行了頻率特性分析,尋找前庭半規(guī)管振動(dòng)的特異性。研究發(fā)現(xiàn)水平半規(guī)管嵴頂橢圓囊側(cè)表面的振動(dòng)幅值對(duì)轉(zhuǎn)動(dòng)加速度較敏感,而管側(cè)表面對(duì)轉(zhuǎn)動(dòng)速度較敏感,嵴頂振動(dòng)的相位只與外載荷頻率相關(guān)。隨著外界載荷頻率增大,水平半規(guī)管嵴頂兩側(cè)的振動(dòng)幅值和相位差均增大。根據(jù)這一特異性,可以通過(guò)臨床旋轉(zhuǎn)試驗(yàn)定位評(píng)估水平半規(guī)管功能。 4、進(jìn)行了環(huán)境溫度激勵(lì)下人雙耳前庭半規(guī)管平衡機(jī)制的數(shù)值分析。結(jié)果表明在外耳道口持續(xù)灌注冷熱水或氣,水平半規(guī)管被激勵(lì)約20s后,前半規(guī)管才被穩(wěn)定激勵(lì)；約40s后,后半規(guī)管被穩(wěn)定激勵(lì)。推測(cè)臨床Hallpike冷熱試法對(duì)前后半規(guī)管功能的評(píng)估不可靠。為了通過(guò)冷熱試法可靠地評(píng)定前后半規(guī)管的功能,需要延長(zhǎng)在外耳道口灌注冷熱水或氣的時(shí)間,這個(gè)規(guī)律適用于任何頭位冷熱試驗(yàn)評(píng)定前庭半規(guī)管功能。 5、探討了橢圓囊內(nèi)淋巴閥在人內(nèi)耳前庭半規(guī)管平衡機(jī)制中的作用,對(duì)尚未明確的橢圓囊內(nèi)淋巴閥的功能進(jìn)行了探索。橢圓囊內(nèi)淋巴閥張開后,任意頭位變化,會(huì)使得內(nèi)耳膜迷路上部和下部的內(nèi)淋巴液體積不等量交換。如果體位變化激勵(lì)越大,橢圓囊內(nèi)淋巴閥的開口面積越大,通過(guò)開口交換的內(nèi)淋巴液的體積將越多,對(duì)嵴頂變形運(yùn)動(dòng)的影響會(huì)越大,從而影響半規(guī)管的平衡機(jī)制。本文研究結(jié)果表明,橢圓囊內(nèi)淋巴閥在前庭半規(guī)管行使平衡功能的過(guò)程中起著重要作用,如果其功能異常,可能增加梅尼埃病和良性陣發(fā)性位置性眩暈等前庭疾病的發(fā)生幾率。
[Abstract]:The vestibular system plays an important role in maintaining body balance . However , because of the deep buried depth and complicated structure of the inner ear , the etiology and pathogenesis of vestibular disorders need to be clarified .

1 . Based on the study of the inner ear structure of guinea pig , the effective method of three - dimensional reconstruction of the inner ear structure of guinea pig was obtained . On the basis of this , the geometric structure was reconstructed by using the data of the semicircular canal structure of the inner ear of a normal person . The frequency of the system was 13.46 Hz , which was much higher than that of the human daily natural frequency and the frequency of clinical rotation test and cold - heat test .

The results show that the mechanical response amplitude and phase of the symmetric semi - regulation tube are equal , the phase difference is 3.14rad , the mechanical response amplitude and the phase of the symmetric semi - regulation tube are equal to each other , so that the stimulus of the symmetric semi - regulation tube is the same .

The results showed that the amplitude of the vibration amplitude on the lateral surface of the horizontal semicircular canal was sensitive to the rotational acceleration , while the phase of the crest vibration was only correlated with the frequency of the external load .

4 . The numerical analysis of the balance mechanism of the vestibular semicircular canal at ambient temperature was carried out . The results showed that cold or hot water or gas was continuously infused at the external auditory canal , and the front semi - regulation tube was excited about 20s after the horizontal semicircular canal was excited about 20s ;
In order to evaluate the function of the anterior and posterior semicircular canal reliably by means of cold - hot test , it is necessary to prolong the time of cold - hot water or gas filling at the mouth of the external ear canal . This rule is applicable to the evaluation of the vestibular semicircular canal function in any head - position cold - heat test .

5 . The function of the lymphatic valve in the anterior vestibular semicircular canal was discussed . After the expansion of the lymphatic valve in the oval capsule , the larger the opening area of the lymphatic valve in the oval capsule , the larger the opening area of the lymphatic valve in the oval capsule , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid exchanged by the opening , the greater the volume of the inner lymphatic fluid through the opening , the greater the volume of the inner lymphatic fluid through the opening , and the greater the probability of occurrence of vestibular diseases , such as meloniere ' s disease and benign paroxysmal positional vertigo .

【學(xué)位授予單位】：大連理工大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R318.01

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張連山;前庭學(xué)進(jìn)展概況[J];中國(guó)耳鼻咽喉頭頸外科;2004年01期

2 盧瑞梁;高明勇;譚湘萍;陳穎瑜;;3T MRI在內(nèi)耳診斷中的應(yīng)用[J];放射學(xué)實(shí)踐;2008年09期

3 劉陽(yáng);計(jì)算機(jī)輔助顳骨結(jié)構(gòu)三維重建[J];國(guó)外醫(yī)學(xué).耳鼻咽喉科學(xué)分冊(cè);1996年03期

4 馬兆鑫;顳骨組織連續(xù)切片三維重建的臨床意義[J];國(guó)外醫(yī)學(xué)(耳鼻咽喉科學(xué)分冊(cè));1998年03期

5 吳子明;耳石器功能的臨床檢查[J];國(guó)外醫(yī)學(xué)(耳鼻咽喉科學(xué)分冊(cè));2003年04期

6 Honrubia V ,林志宏;老年人平衡障礙的發(fā)病率、病因、檢查及治療[J];國(guó)外醫(yī)學(xué).耳鼻咽喉科學(xué)分冊(cè);1991年04期

7 沈雙;孫秀珍;劉迎曦;;人前庭系統(tǒng)膜迷路生物力學(xué)模型研究[J];哈爾濱工業(yè)大學(xué)學(xué)報(bào);2011年S1期

8 劉海燕;朱佳;;老年眩暈診治體會(huì)[J];湖南中醫(yī)雜志;2009年05期

9 魏慶堂,牛洪濤,周晶;多層CT三維成像在先天性外、中、內(nèi)耳畸形中的應(yīng)用[J];哈爾濱醫(yī)科大學(xué)學(xué)報(bào);2003年06期

10 裴靜琛,常磊,劉志強(qiáng),王林杰,李偉剛,孫若亮;航天員前庭功能的選拔[J];航天醫(yī)學(xué)與醫(yī)學(xué)工程;2003年S1期

，

本文編號(hào)：1896610