本文選題：閉角型青光眼 + 虹膜膨隆��； 參考：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景原發(fā)性閉角型青光眼(Primary angle closure glaucoma,PACG)是由于虹膜組織發(fā)生非正常變形而致使前房角被虹膜組織物理性關(guān)閉,嚴(yán)重阻礙房水的循環(huán)流動(dòng),并由此造成房水眼壓值升高的典型青光眼疾病。其發(fā)病率我國(guó)各地區(qū)均較高,而且有進(jìn)一步惡化的趨勢(shì)。已有研究顯示虹膜膨隆對(duì)房水循環(huán)會(huì)產(chǎn)生較大影響,因而深入研究虹膜膨隆對(duì)房水循環(huán)的影響,對(duì)PACG的臨床診斷、病情發(fā)展以及治療有重要的指導(dǎo)意義。目前采用實(shí)驗(yàn)手段研究虹膜膨隆情況下房水的流動(dòng)情況存在較多的不便,因而需要尋找合適的方法來(lái)研究虹膜膨隆情況下房水流動(dòng)以及虹膜膨隆與眼壓之間的變化關(guān)系。目的采用ANSYS-FLUENT軟件建立二維人眼前房仿真模型,模擬虹膜膨隆情況下房水從前房到后房的整個(gè)流動(dòng)過(guò)程。采用該模型分析三種典型虹膜膨隆情況對(duì)眼內(nèi)壓變化的影響并分析其變化原因。相關(guān)結(jié)果可以為預(yù)防、診斷PACG病情以及預(yù)測(cè)病情發(fā)展提供一定理論指導(dǎo)。方法1.在超聲生物顯微鏡掃描結(jié)果的基礎(chǔ)上采用CAD制圖軟件構(gòu)建了以人眼前房為主的二維立位(體)幾何模型。通過(guò)對(duì)已有病人虹膜膨隆圖像資料的分析,考慮虹膜膨隆夾角的大小,將虹膜膨隆簡(jiǎn)化為三種類型。這三類夾角分別對(duì)應(yīng)虹膜的膨隆程度如下:正常夾角(49°),中等寬角(30°),極窄角(10°)。2.將虹膜膨隆幾何模型導(dǎo)入有限元分析軟件ANSYS14.0中。在模擬過(guò)程中認(rèn)為虹膜,角膜和晶狀體為剛性,直接忽略其厚度方向的變形,且不考慮房水流動(dòng)過(guò)程中的變形情況。另外在虹膜膨隆眼球房水的流動(dòng)過(guò)程中,在疾病沒(méi)有進(jìn)一步發(fā)展時(shí),某一段時(shí)間內(nèi)可以認(rèn)為眼壓值已經(jīng)趨于穩(wěn)定。此時(shí)虹膜的半徑可以認(rèn)為是定值且厚度變化對(duì)房水流動(dòng)的影響較小,主要的影響因素為虹膜膨隆的半徑對(duì)前后房體積造成的影響。3.考慮房水入口、出口以及虹膜和晶狀體接觸附近為房水流動(dòng)復(fù)雜區(qū)域,因而對(duì)這三部分進(jìn)行網(wǎng)格加密。將房水,虹膜,晶狀體等相關(guān)結(jié)構(gòu)的物性參數(shù)賦值給網(wǎng)格模型,并設(shè)定房水入口及出口流速等相關(guān)邊界條件。4.利用Fluent求解器迭代求解,整理得到三種虹膜膨隆情況對(duì)應(yīng)的眼內(nèi)壓和溫度分布計(jì)算結(jié)果。根據(jù)計(jì)算結(jié)果分析虹膜膨隆對(duì)眼內(nèi)壓的影響。結(jié)果1.虹膜膨隆僅僅對(duì)虹膜附近的溫度場(chǎng)分布有影響,遠(yuǎn)離虹膜的房水溫度場(chǎng)分布基本和正常眼球內(nèi)部溫度分布場(chǎng)一致。計(jì)算結(jié)果表明虹膜膨隆較為嚴(yán)重時(shí),前后房眼內(nèi)壓的差值急劇上升,但是眼前房溫度分布變化依然較小。2.在正常眼球和虹膜膨隆眼球中后房和前房各自的壓力場(chǎng)均基本不變,但是前后房的壓差值變化較大。由于虹膜膨隆造成了前房縮小,后房擴(kuò)大;同時(shí)考慮房水的流動(dòng)過(guò)程中其流量保持不變,因而在正常眼球瞳孔附近后房房水的流速大于虹膜膨隆眼球中后房房水的流速。3.隨著虹膜膨隆程度的增加,即膨隆夾角的減小,前房更加縮小和后房更加擴(kuò)大,因而虹膜膨隆眼球中前后房房水的壓力值隨膨隆夾角的減小而增加。結(jié)論當(dāng)虹膜膨隆夾角為30°時(shí),壓差值相對(duì)于正常眼球值變化不是很大。然而當(dāng)虹膜膨隆較為嚴(yán)重,膨隆夾角為10°時(shí),壓差值極大增加。這說(shuō)明在虹膜膨隆早期眼壓變化較小,然而當(dāng)虹膜膨隆到一定程度,眼壓值迅速增加,如不及時(shí)控制眼壓,病情會(huì)迅速加劇。該研究初步揭示了虹膜膨隆對(duì)房水流動(dòng)的影響,為該類閉角型青光眼病情的臨床診斷以及病情的發(fā)展提供了理論支撐。
[Abstract]:Background primary angle closure glaucoma (Primary angle closure glaucoma, PACG) is a typical green eye disease caused by abnormal deformation of the iris tissue that causes the anterior chamber angle to be physically closed by the iris tissue, which seriously hinders the circulating flow of aqueous humor, and thus causes an elevated ocular pressure in the aqueous humor. The incidence of the disease is higher in all regions of China. There is a trend of further deterioration. Previous studies have shown that iris swelling will have a great impact on the circulation of aqueous humor. Therefore, it is important to study the effect of iris swelling on the circulation of aqueous humor. It has important guiding significance for the clinical diagnosis, development and treatment of PACG. In the case of more inconveniences, it is necessary to find a suitable method to study the relationship between the flow of aqueous humor in the iris bulging and the relationship between the iris swelling and the intraocular pressure. Objective to establish a two-dimensional human anterior chamber simulation model with ANSYS-FLUENT software to simulate the whole flow process of the former room to the rear room under the condition of iris expansion. Analysis of the effects of three typical iris bulging on intraocular pressure changes and analysis of the causes of changes. The results can provide some theoretical guidance for the prevention, diagnosis of PACG condition and prediction of the development of the disease. Method 1. based on the results of ultrasound biomicroscopy, the CAD mapping software is used to build a two-dimensional room with the anterior chamber. By analyzing the image data of the iris bulging of the patients, the iris bulging is simplified into three types by considering the size of the iris expansion angle. The three types of angles corresponding to the iris expansion are as follows: the normal angle (49), the medium width angle (30 degrees), and the extremely narrow angle (10 degrees).2.. In the finite element analysis software ANSYS14.0, the iris, cornea and lens are considered to be rigid in the simulation process, and the deformation of the thickness direction is ignored directly, and the deformation in the process of aqueous fluid flow is not considered. In addition, intraocular pressure can be considered in a certain period of time when the disease has not been developed step by step in the flow process of the iris bulging eyeball room. At this time, the radius of the iris can be considered as the fixed value and the influence of the thickness change on the flow of the aqueous humor is small. The main influence factor is the effect of the radius of the iris on the volume of the front and rear rooms.3., the entrance of the aqueous humor is considered, the exit and the contact of the iris and the lens are close to the complex area of the aqueous fluid flow, so the three The physical parameters of the related structures such as aqueous humor, iris, lens and other related structures are assigned to the grid model, and the relative boundary conditions of the inlet and exit velocity of the aqueous humor are set by the Fluent solver iterative solution, and the results of the calculation of the intraocular pressure and temperature distribution corresponding to three iris bulging conditions are obtained. The results are divided according to the calculation results. The effect of iris bulging on intraocular pressure. Results 1. iris swelling is only affected by the distribution of temperature field near the iris. The distribution of the temperature field far away from the iris is basically the same as the temperature distribution field in the normal eyeball. The distribution changes are still small.2. in the normal eyeball and the iris bulging eyeball, the pressure field of the posterior chamber and the front room is basically unchanged, but the pressure difference between the front and back rooms varies greatly. As the iris enlargement causes the anterior chamber to shrink and the rear room is enlarged, the flow of the room water remains unchanged in the course of the flow of the aqueous humor, so it is near the normal eye pupil. The velocity of water in the posterior chamber is greater than the flow velocity of the iris in the posterior chamber of the iris, with the increase of the iris swelling, that is, the expansion angle decreases, the front room is narrower and the posterior chamber is more enlarged. Therefore, the pressure value of the anterior chamber water in the iris bulging eyeball increases with the increase of the expansion angle. Conclusion when the iris angle is 30 degrees, the iris expansion angle is 30 degrees. The difference in pressure difference is not very large relative to the normal eyeball value. However, when the iris expansion is more serious and the expansion angle is 10 degrees, the difference of pressure increases greatly. This indicates that the change of intraocular pressure is smaller in the early stage of iris expansion. However, when the iris expands to a certain extent, the value of intraocular pressure increases rapidly, if the intraocular pressure is not controlled in time, the condition will rapidly increase. The initial study of the disease will rapidly increase. It reveals the influence of iris expansion on the flow of aqueous humor, and provides theoretical support for the clinical diagnosis and the development of the disease.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R775

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郭競(jìng)敏;張虹;王軍明;;人眼前房三維重建與房水流場(chǎng)數(shù)值模擬[J];眼科新進(jìn)展;2015年04期

2 繩偉東;;內(nèi)蒙古扎蘭屯市中老年人群中原發(fā)性閉角型青光眼流行病學(xué)調(diào)查[J];中國(guó)實(shí)用醫(yī)藥;2014年24期

3 梁書秀;郝菲菲;孫昭晨;邵彥;李亞新;;基于Fluent的白內(nèi)障術(shù)后房水流體力學(xué)數(shù)值分析[J];暨南大學(xué)學(xué)報(bào)(自然科學(xué)與醫(yī)學(xué)版);2014年04期

4 王懷洲;王寧利;;原發(fā)性閉角型青光眼發(fā)病機(jī)制與防治體系的建立及應(yīng)用——2013年度國(guó)家科學(xué)技術(shù)進(jìn)步二等獎(jiǎng)[J];首都醫(yī)科大學(xué)學(xué)報(bào);2014年01期

5 祁昕征;魏超;楊佳燕;穆晶;張昆亞;劉志成;錢秀清;;三維有限元模型力學(xué)分析可預(yù)測(cè)視乳頭的形狀變化[J];中國(guó)組織工程研究;2013年50期

6 姜宗來(lái);;我國(guó)生物力學(xué)研究現(xiàn)狀與展望[J];中國(guó)生物醫(yī)學(xué)工程學(xué)報(bào);2011年02期

7 趙慧;陳雪藝;王燕;趙菊芳;李晉;付勁;;新疆烏魯木齊市50歲及以上體檢人群青光眼構(gòu)成情況[J];新疆醫(yī)科大學(xué)學(xué)報(bào);2009年02期

8 陳琛;劉曉華;林丁;劉志成;張昆亞;宋紅芳;;基于定量瞳孔阻滯力仿真實(shí)驗(yàn)的虹膜組織生物力學(xué)特性分析[J];眼科新進(jìn)展;2006年04期

9 任百超,何媛,陳莉,楊建剛,孫乃學(xué);陜西省農(nóng)村人群青光眼的流行病學(xué)調(diào)查[J];國(guó)際眼科雜志;2005年05期

10 王寧利 ,吳河坪 ,范志剛;中國(guó)人原發(fā)性閉角型青光眼的研究進(jìn)展(英文)[J];Chinese Medical Journal;2002年11期

相關(guān)會(huì)議論文 前1條

1 田晗菁;杜睿琪;宋凡;;眼壓作用下篩板的力學(xué)行為分析[A];中國(guó)力學(xué)大會(huì)-2015論文摘要集[C];2015年

相關(guān)博士學(xué)位論文 前1條

1 郭競(jìng)敏;原發(fā)性閉角型青光眼房角關(guān)閉的力學(xué)機(jī)制研究[D];華中科技大學(xué);2015年

相關(guān)碩士學(xué)位論文 前3條

1 郝菲菲;基于CFD的眼球內(nèi)房水流動(dòng)數(shù)值分析[D];大連理工大學(xué);2014年

2 郁琪華;白內(nèi)障超聲乳化吸出聯(lián)合人工晶體植入術(shù)后眼前節(jié)變化的研究[D];天津醫(yī)科大學(xué);2007年

3 劉清云;人工晶體袢的角度與后發(fā)性白內(nèi)障相關(guān)性的研究[D];大連醫(yī)科大學(xué);2003年

，

本文編號(hào)：2020955