本文選題：手術(shù)縫合線 + 生物軟組織��； 參考：《西南交通大學》2017年碩士論文

【摘要】：隨著醫(yī)療科技的不斷進步,微創(chuàng)外科手術(shù)不斷地向自動化、智能化方向發(fā)展。微創(chuàng)手術(shù)縫合操作是一項繁瑣、耗時和復雜的工作,縫合的效率直接影響著整個手術(shù)的成敗。手術(shù)縫合操作可分為縫合、打結(jié)兩個動作。在縫合過程中,手術(shù)縫合線與生物軟組織界面的摩擦特性嚴重影響著手術(shù)縫合效率,而在打結(jié)過程中,結(jié)的可靠性主要受到縫合線與縫合線界面摩擦性能的影響。本文模擬手術(shù)縫合打結(jié)操作,研究了不同手術(shù)操作參數(shù)和縫合線設計參數(shù)對其摩擦性能的影響。開展的主要工作和相關(guān)結(jié)論如下:模擬手術(shù)打結(jié)操作,利用生物力學試驗機(型號:HY0580)研究了載荷、縫合線表面結(jié)構(gòu)和速度對縫合線-縫合線界面的摩擦特性的影響。實驗結(jié)果表明:縫合線的摩擦性能受到載荷和縫合線表面結(jié)構(gòu)影響,而與縫合線移動速度無關(guān)。隨著載荷的增大,線-線界面摩擦力增大。單絲結(jié)構(gòu)和表面涂層可以有效的降低縫合線的表面粗糙度,從而減小縫合線的摩擦力。模擬手術(shù)縫合操作,以CETR多功能摩擦磨損試驗機為實驗裝置主體,建立了縫合線法向加載的單方向縫合線-軟組織表面滑動模型。以人造皮膚、豬肌肉、豬肝臟三種組織為實驗樣品,復絲縫合線(絲線)、單絲縫合線(聚丙烯縫合線)和有涂層復絲縫合線(聚乳糖酸910縫合線)三種不同表面結(jié)構(gòu)的縫合線為實驗對象,將法向載荷分別置為0.1 N到0.5 N,滑移速度分別置為5 mm/s到25 mm/s進行了手術(shù)縫合線-生物軟組織界面摩擦實驗。實驗結(jié)果表明:1.縫合線-生物軟組織界面的摩擦系數(shù)隨著法向載荷的增大而減小,隨著滑移速度的增大而增大。這主要與軟組織的非線性粘彈性性能和變形滯后性能有關(guān)。2.縫合線的表面涂層和單絲涂層可以降低表面粗糙度和表面吸附性能,從而有效的降低縫合線-軟組織界面的摩擦系數(shù)。3.相比于人造皮膚,豬肝臟和豬肌肉中存在這大量的生物液體(組織液、血液)可對縫合線-軟組織界面起到潤滑作用,從而降低界面的粘附摩擦系數(shù)。
[Abstract]:With the development of medical science and technology, minimally invasive surgery is developing towards automation and intelligence. Minimally invasive suture is a complicated, time-consuming and complicated operation, and the efficiency of suture directly affects the success or failure of the operation. Suture operation can be divided into two movements: suture and knot. In the process of suture, the friction characteristics of the interface between the suture and the biological soft tissue seriously affect the efficiency of the suture, while the reliability of the knot is mainly affected by the friction between the suture and the suture. In this paper, the effects of different operation parameters and suture design parameters on the friction performance of the suture knots are studied. The main work and related conclusions are as follows: the effects of load, surface structure and velocity of suture on the friction characteristics of suture-suture interface are studied by using biomechanical testing machine (type: HY0580). The experimental results show that the friction performance of the suture is affected by the load and the surface structure of the suture, but not by the speed of the suture movement. With the increase of load, the friction at the line-line interface increases. Monofilament structure and surface coating can effectively reduce the surface roughness of stitches and thus reduce the friction of stitches. In order to simulate the operation of suture, a single direction suture line surface sliding model with normal loading of suture line was established with CETR multifunctional friction and wear tester as the main body of the experiment device. Three kinds of tissues, artificial skin, pig muscle and pig liver, were used as experimental samples. Three kinds of suture lines with different surface structures (silk thread, monofilament suture (polypropylene suture) and coated multifilament suture (polylactate 910 suture) were used as experimental objects. The normal load is 0. 1 N to 0. 5 N, and the slip velocity is 5 mm/s to 25 mm/s. The friction experiment between suture line and biological soft tissue interface is carried out. The result of the experiment shows that 1: 1. The friction coefficient between suture and biological soft tissue decreases with the increase of normal load and increases with the increase of slip velocity. This is mainly related to the nonlinear viscoelastic properties and deformation hysteresis properties of soft tissue. The surface roughness and adsorption property of the suture line can be reduced by the surface coating and the monofilament coating, which can effectively reduce the friction coefficient of the suture and soft tissue interface. Compared with artificial skin, the presence of this large amount of biological fluid (tissue fluid, blood) in porcine liver and muscle can lubricate the suture and soft tissue interface, thus reducing the friction coefficient of the interface.
【學位授予單位】：西南交通大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R61;R318.01

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