本文選題：骨質(zhì)疏松　切入點(diǎn)：股骨頸　出處：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的:骨質(zhì)疏松是一種全身性骨代謝性疾病,其引起的椎體骨折、股骨頸骨折是臨床常見的病理性骨折,是老年患者死亡的主要威脅因素。臨床上常用經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)和經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)治療骨質(zhì)疏松性椎體壓縮性骨折(osteoporotic vertebral compression fractures,OVCF)。本實(shí)驗(yàn)旨在研究骨水泥對(duì)骨質(zhì)疏松性股骨頸的生物力學(xué)影響及有限元分析,為臨床防治骨質(zhì)疏松性股骨頸骨折提供新的選擇和思路。方法:(一)生物力學(xué)實(shí)驗(yàn):健康雌性中國大白兔21只,適應(yīng)性飼養(yǎng)2周行股骨頸骨密度測定后隨機(jī)分為3組,分別為實(shí)驗(yàn)組、對(duì)照組、假手術(shù)組。實(shí)驗(yàn)組和對(duì)照組給予去勢(shì)+激素注射進(jìn)行骨質(zhì)疏松造模,待造模成功后,實(shí)驗(yàn)組給予股骨頸注射骨水泥,對(duì)照組不注射骨水泥,假手術(shù)組僅行與實(shí)驗(yàn)組、對(duì)照組行相同的手術(shù)方式而不做其他任何處理。6周后對(duì)所有實(shí)驗(yàn)動(dòng)物的股骨進(jìn)行完整的CT掃描,隨后處死所有試驗(yàn)動(dòng)物,離取實(shí)驗(yàn)所需的股骨標(biāo)本后,剔除附著在骨表面的肌腱及軟組織,低溫儲(chǔ)存直至生物力學(xué)測量。室溫自然解凍后,截取并制作生物力學(xué)測量所需的試樣,并在生物力學(xué)機(jī)上按照之前的實(shí)驗(yàn)設(shè)計(jì)進(jìn)行壓縮試驗(yàn),記錄數(shù)據(jù)并觀察試樣斷裂位置。(二)有限元分析:實(shí)驗(yàn)標(biāo)本掃描數(shù)據(jù)以DICOM(Digital Imaging and Communications in Medicine)格式儲(chǔ)存,將DICOM格式的掃描數(shù)據(jù)導(dǎo)入Mimics Research 17.0(Materialise's interactive medical image control system),在Mimics中利用不同組織間閾值的不同,進(jìn)行分割及三維重建,導(dǎo)入到3-Matic之后進(jìn)行網(wǎng)格優(yōu)化和網(wǎng)格劃分,將體網(wǎng)格模型導(dǎo)回Mimics進(jìn)行材料賦值,再將賦值完成的體網(wǎng)格模型導(dǎo)入到ABAQUS 6.14進(jìn)行求解分析,然后定義載荷和邊界約束條件,最后提交分析處理。結(jié)果:(一)生物力學(xué)實(shí)驗(yàn)結(jié)果:壓縮實(shí)驗(yàn)結(jié)果表明,實(shí)驗(yàn)組與對(duì)照組相比,在彈性模量、斷裂點(diǎn)載荷、斷裂點(diǎn)應(yīng)力、載荷最大值、應(yīng)力最大值等方面,差異具有統(tǒng)計(jì)學(xué)意義,P0.05,而和假手術(shù)組相比,差異無統(tǒng)計(jì)學(xué)意義,P0.05。(二)有限元分析:通過Mimics和ABAQUS我們建立了股骨頸的三維有限元模型,獲得了有限元網(wǎng)格,實(shí)驗(yàn)組單元數(shù)為256559、節(jié)點(diǎn)數(shù)為329102,對(duì)照組單元數(shù)為222705、節(jié)點(diǎn)數(shù)為277455,假手術(shù)組單元數(shù)為222053、節(jié)點(diǎn)數(shù)為318231;通過ABAQUS求解分析發(fā)現(xiàn),在同等加載條件下,實(shí)驗(yàn)組的剛度最大、假手術(shù)組次之、對(duì)照組最差。結(jié)論:注射骨水泥可以增加骨質(zhì)疏松性股骨頸的生物力學(xué)強(qiáng)度,為臨床防治骨質(zhì)疏松性股骨頸骨折提供新的策略。
[Abstract]:Objective: osteoporosis is a systemic bone metabolic disease, which causes vertebral fracture and femoral neck fracture is a common pathological fracture in clinic. Percutaneous vertebroplasty and percutaneous kyphoplasty PKP are commonly used in the treatment of osteoporotic vertebral compression fracture of osteoporotic vertebral body compression fracture. The purpose of this study was to study the effect of percutaneous vertebroplasty and percutaneous kyphoplastic kyphoplastic kyphoplasty on the treatment of osteoporotic vertebral compression fracture. The purpose of this study was to study the effect of percutaneous vertebroplasty and kyphoplastic kyphoplasty PKP on the treatment of osteoporotic vertebral compression fracture. Biomechanical effect and finite element Analysis of Osteoporosis femoral neck, Methods (1) Biomechanical experiment: 21 healthy female Chinese rabbits were randomly divided into 3 groups after 2 weeks of adaptive feeding. The experimental group and control group were injected with ovariectomized hormone to make model of osteoporosis. After successful modeling, the experimental group was given femoral neck injection of bone cement, and the control group was not injected with bone cement. The sham-operated group was treated with the same operation as the experimental group, and the control group underwent the same operation without any other treatment. After 6 weeks of treatment, the femur of all the experimental animals were scanned by CT, then all the experimental animals were killed, and the femur specimens were removed from the experimental animals. Remove tendons and soft tissue attached to the surface of bone, store at low temperature until biomechanical measurement. After natural thawing at room temperature, intercept and make samples for biomechanical measurement. Compression tests were carried out on a biomechanical machine according to the previous experimental design. The data were recorded and observed. (2) finite element analysis. The scanning data were stored in the format of DICOM(Digital Imaging and Communications in Medicine. The scanning data in DICOM format are imported into Mimics Research 17.0(Materialise's interactive medical image control system, and the different thresholds of different tissues are used in Mimics to segment and reconstruct 3D, and then the meshes are optimized and meshed after being imported into 3-Matic. The volume mesh model is introduced back to Mimics for material assignment, and then the volume grid model is imported into ABAQUS 6.14 to solve the problem, and then the load and boundary constraints are defined. Results: compression experiment results showed that, compared with the control group, the experimental group had the following aspects: elastic modulus, fracture point load, fracture point stress, maximum load, maximum stress, and so on. The difference was statistically significant (P 0.05), but there was no significant difference compared with sham operation group (P 0.05) (2) finite element analysis: through Mimics and ABAQUS we established a three-dimensional finite element model of femoral neck and obtained finite element mesh. The experimental group had 2565559 units, 329102 nodes, the control group 222705 units, the node number 277455, the sham-operation group 222053 units, the node number 318231.The results of ABAQUS solution analysis showed that under the same loading conditions, the stiffness of the experimental group was the greatest, followed by the sham operation group. Conclusion: bone cement injection can increase the biomechanical strength of osteoporotic femoral neck and provide a new strategy for clinical prevention and treatment of osteoporotic femoral neck fracture.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687

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