基于流固耦合理論的男性下尿路生物力學(xué)研究
發(fā)布時間：2018-11-07 15:12
【摘要】：男性膀胱下尿路梗阻發(fā)病率極高,任何年齡均可發(fā)生。下尿路梗阻早期的客觀表現(xiàn)為尿動力學(xué)改變,故尿動力學(xué)檢查可較早發(fā)現(xiàn)下尿路梗阻,但現(xiàn)有尿動力學(xué)檢查手段對尿路正常生理活動存在干擾,并影響受檢查者的精神和心理。針對上述問題,本文基于流固耦合理論對男性下尿路開展生物力學(xué)研究,為應(yīng)用尿路流體仿真進(jìn)行無創(chuàng)性尿動力學(xué)檢測提供理論支撐,也為下尿路梗阻的診斷、治療提供理論基礎(chǔ)。本文首先應(yīng)用火棉膠薄型化連續(xù)斷層切片技術(shù),闡明膀胱出口及尿道復(fù)雜結(jié)構(gòu),建立高度仿真的無梗阻、輕度梗阻、中度梗阻、重度梗阻四種下尿路幾何模型(包括膀胱、前列腺、尿道膜部括約肌、尿道、尿液流場模型)。隨后進(jìn)行了兩類、四組共23次仿真計算:在正常排尿過程逼尿肌壓力范圍內(nèi)取5個壓力值30、40、50、60、70cmH2O,分別對這5種逼尿肌壓力下正常排尿過程進(jìn)行流固耦合計算;在前列腺尿道梗阻排尿過程逼尿肌壓力范圍內(nèi)取6個壓力值50、70、90、110、130、150cmH2O,分別對這6種逼尿肌壓力下三種不同程度前列腺尿道梗阻排尿過程進(jìn)行流固耦合計算。經(jīng)過數(shù)值模擬得到尿流率、排尿時壓力-尿流率曲線、尿道壓力分布等尿動力學(xué)參數(shù)及下尿路各器官的應(yīng)力、變形情況。對正常排尿過程固體域VonMises應(yīng)力、位移進(jìn)行分析,結(jié)果表明膀胱頸、尿道膜部區(qū)域容易發(fā)生病變;正常排尿過程流體域分析結(jié)果表明流體域的總壓、速度、渦量、壁面切應(yīng)力隨著入口壓力升高,整體上逐漸變大,尿道后壁面承受的壁面切應(yīng)力較大,較前壁面容易發(fā)生損傷。對前列腺尿道梗阻排尿過程固體域Von Mises應(yīng)力、位移進(jìn)行分析,結(jié)果表明梗阻情況較無梗阻情況膀胱頸區(qū)域更容易發(fā)生病變,且梗阻程度越嚴(yán)重,膀胱頸區(qū)域發(fā)生病變可能性越大;前列腺尿道梗阻排尿過程流體域分析結(jié)果表明梗阻情況下前列腺區(qū)域,特別是前列腺區(qū)域末端接近尿道膜部的位置容易發(fā)生病變,且梗阻越嚴(yán)重,前列腺區(qū)域末端接近尿道膜部位置越容易發(fā)生病變,整個尿道后壁面更容易發(fā)生病變,流體域各個部位的速度、渦量分布與梗阻程度不存在明顯的聯(lián)系。根據(jù)仿真結(jié)果繪制的壓力-流率曲線以及尿道壓力分布曲線,與臨床檢測結(jié)果一致,說明尿路流體仿真應(yīng)用于尿道梗阻等下尿路疾病的診斷可行性較高,對于推動尿路流體仿真替代現(xiàn)有尿動力學(xué)檢測手段具有重要意義。本文通過分析多種情況下的尿流動力學(xué)行為及其對下尿路的影響,為下尿路疾病的發(fā)展預(yù)判提供了參考,對其臨床診斷、改進(jìn)手術(shù)治療方案起到了一定的指導(dǎo)作用。
[Abstract]:The incidence of subbladder obstruction in men is extremely high and can occur at any age. The early objective manifestation of lower urinary tract obstruction is the change of urodynamics, so urodynamic examination can find the lower urinary tract obstruction earlier, but the existing methods of urodynamic examination interfere with the normal physiological activities of urinary tract and affect the mental and psychological status of the subjects. In view of the above problems, the biomechanical study of male lower urinary tract was carried out based on fluid-solid coupling theory, which provided theoretical support for non-invasive urodynamic test using fluid simulation of urinary tract, and was also used for the diagnosis of lower urinary tract obstruction. Treatment provides a theoretical basis. In this paper, the technique of thin continuous slice section of sponge gum was used to clarify the complex structure of bladder outlet and urethra, and four kinds of geometric models of lower urinary tract (including bladder, bladder) were established, which were highly simulated without obstruction, mild obstruction, moderate obstruction and severe obstruction. Prostate, urethral sphincter, urethra, urine flow field model. Then two kinds of simulations were carried out in four groups. In the range of detrusor pressure during normal urination, 5 pressure values of 30 ~ 40 ~ 50U ~ (60) C ~ (70) cm _ H _ 2O were taken to calculate the fluid-solid coupling of the normal urination process under these five kinds of detrusor pressure. In the range of detrusor pressure of prostatic urethral obstruction (BUO), six pressure values of 50 ~ 70,90110130150cmH _ 2O were collected and calculated by fluid-solid coupling for three different degrees of prostatic urethral obstruction under these six kinds of detrusor pressures. The urodynamic parameters, such as uroflow rate, pressure-uroflow rate curve, urethral pressure distribution, and stress and deformation of various organs in the lower urinary tract were obtained by numerical simulation. The VonMises stress and displacement in the solid region during normal urination were analyzed. The results showed that the bladder neck and urethral membrane region were prone to pathological changes. The results of fluid domain analysis during normal urination showed that the total pressure, velocity, vorticity and wall shear stress of the fluid region increased with the increase of inlet pressure, and gradually increased as a whole. The wall shear stress on the posterior wall of urethra was larger than that on the front wall, which was more easily damaged than that of the front wall. The stress and displacement of Von Mises in the solid region during the urination process of prostatic urethral obstruction were analyzed. The results showed that the obstruction was more likely to occur in the bladder neck area than that in the non-obstruction condition, and the more serious the obstruction was, the more severe the urethral obstruction was. The greater the possibility of bladder neck lesion; The fluid domain analysis of urethral obstruction showed that the location of the prostate region, especially the end of the prostate region near the urethral membrane, was easy to occur in the case of obstruction, and the more serious the obstruction, the more serious the urethral obstruction was. The closer the end of the prostate region is to the urethral membrane, the easier it is to change the whole posterior urethral wall. There is no obvious relationship between the velocity and vorticity distribution of the fluid region and the degree of obstruction. The curves of pressure-flow rate and urethral pressure distribution were drawn according to the simulation results, which were consistent with the clinical results, which indicated that the application of fluid simulation in the diagnosis of lower urinary tract diseases such as urethral obstruction was more feasible. It is of great significance to promote urologic fluid simulation to replace existing urodynamic testing methods. By analyzing the urodynamic behavior and its influence on the lower urinary tract under various conditions, this article provides a reference for the development of lower urinary tract disease, and plays a certain guiding role in clinical diagnosis and improvement of surgical treatment.
【學(xué)位授予單位】：天津科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R318.01;R691.2
本文編號：2316750
[Abstract]:The incidence of subbladder obstruction in men is extremely high and can occur at any age. The early objective manifestation of lower urinary tract obstruction is the change of urodynamics, so urodynamic examination can find the lower urinary tract obstruction earlier, but the existing methods of urodynamic examination interfere with the normal physiological activities of urinary tract and affect the mental and psychological status of the subjects. In view of the above problems, the biomechanical study of male lower urinary tract was carried out based on fluid-solid coupling theory, which provided theoretical support for non-invasive urodynamic test using fluid simulation of urinary tract, and was also used for the diagnosis of lower urinary tract obstruction. Treatment provides a theoretical basis. In this paper, the technique of thin continuous slice section of sponge gum was used to clarify the complex structure of bladder outlet and urethra, and four kinds of geometric models of lower urinary tract (including bladder, bladder) were established, which were highly simulated without obstruction, mild obstruction, moderate obstruction and severe obstruction. Prostate, urethral sphincter, urethra, urine flow field model. Then two kinds of simulations were carried out in four groups. In the range of detrusor pressure during normal urination, 5 pressure values of 30 ~ 40 ~ 50U ~ (60) C ~ (70) cm _ H _ 2O were taken to calculate the fluid-solid coupling of the normal urination process under these five kinds of detrusor pressure. In the range of detrusor pressure of prostatic urethral obstruction (BUO), six pressure values of 50 ~ 70,90110130150cmH _ 2O were collected and calculated by fluid-solid coupling for three different degrees of prostatic urethral obstruction under these six kinds of detrusor pressures. The urodynamic parameters, such as uroflow rate, pressure-uroflow rate curve, urethral pressure distribution, and stress and deformation of various organs in the lower urinary tract were obtained by numerical simulation. The VonMises stress and displacement in the solid region during normal urination were analyzed. The results showed that the bladder neck and urethral membrane region were prone to pathological changes. The results of fluid domain analysis during normal urination showed that the total pressure, velocity, vorticity and wall shear stress of the fluid region increased with the increase of inlet pressure, and gradually increased as a whole. The wall shear stress on the posterior wall of urethra was larger than that on the front wall, which was more easily damaged than that of the front wall. The stress and displacement of Von Mises in the solid region during the urination process of prostatic urethral obstruction were analyzed. The results showed that the obstruction was more likely to occur in the bladder neck area than that in the non-obstruction condition, and the more serious the obstruction was, the more severe the urethral obstruction was. The greater the possibility of bladder neck lesion; The fluid domain analysis of urethral obstruction showed that the location of the prostate region, especially the end of the prostate region near the urethral membrane, was easy to occur in the case of obstruction, and the more serious the obstruction, the more serious the urethral obstruction was. The closer the end of the prostate region is to the urethral membrane, the easier it is to change the whole posterior urethral wall. There is no obvious relationship between the velocity and vorticity distribution of the fluid region and the degree of obstruction. The curves of pressure-flow rate and urethral pressure distribution were drawn according to the simulation results, which were consistent with the clinical results, which indicated that the application of fluid simulation in the diagnosis of lower urinary tract diseases such as urethral obstruction was more feasible. It is of great significance to promote urologic fluid simulation to replace existing urodynamic testing methods. By analyzing the urodynamic behavior and its influence on the lower urinary tract under various conditions, this article provides a reference for the development of lower urinary tract disease, and plays a certain guiding role in clinical diagnosis and improvement of surgical treatment.
【學(xué)位授予單位】：天津科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R318.01;R691.2
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