【摘要】：背景：腦血管病是我國(guó)中老年人群的常見(jiàn)病、多發(fā)病，近年來(lái)呈上升和低齡化趨勢(shì)，具有高發(fā)病率、高死亡率和高致殘率特點(diǎn)，已成為一個(gè)重要的公共衛(wèi)生問(wèn)題。對(duì)于這種疾病臨床醫(yī)學(xué)對(duì)其病因、發(fā)病機(jī)制、臨床表現(xiàn)、診斷、鑒別診斷、治療、預(yù)后等以往認(rèn)識(shí)已較深刻，但對(duì)其局部腦血管流體力學(xué)特征認(rèn)識(shí)尚不清晰，影響對(duì)這些疾病的診療作出更深層次判斷。計(jì)算流體力學(xué)（Computational Fluid Dynamics,CFD)能通過(guò)準(zhǔn)確計(jì)算模擬腦血管的流體力學(xué)特征，圖像直觀明了，為醫(yī)生深入認(rèn)識(shí)腦血流狀態(tài)提供很大幫助。但由于其跨專(zhuān)業(yè)性很少有醫(yī)生認(rèn)識(shí)并應(yīng)用于臨床，應(yīng)用于腦血管病的研究較少，應(yīng)用于腦血管病介入治療的研究更少。 目的：探討腦血管病局部腦血管的建模方法并開(kāi)展數(shù)值模擬研究，提高醫(yī)生對(duì)腦血管病的認(rèn)識(shí)。 方法：選取懷疑有腦血管疾病并做全腦血管造影術(shù)老年患者100例，并在術(shù)中給予腦血管血壓監(jiān)測(cè)，術(shù)后使用MATLAB7.0對(duì)每條監(jiān)測(cè)曲線進(jìn)行函數(shù)擬合，通過(guò)推導(dǎo)建成具有廣泛代表性的腦血管血壓函數(shù)模型，并另選50例患者驗(yàn)證函數(shù)模型的可靠性。另選取做全腦血管造影術(shù)確診的左側(cè)頸內(nèi)動(dòng)脈巨大螺旋形梭狀動(dòng)脈瘤患者一例，女性，67歲，術(shù)中獲得相關(guān)數(shù)據(jù)。術(shù)后使用MIMICS12.0,Geomagic Studio12和UGS NX8.0建模，并和傳統(tǒng)建模方法比較，獲得可靠的腦血管流固耦合模型建模方法。之后使用實(shí)驗(yàn)獲得的腦血管血壓函數(shù)模型和新的建模方法對(duì)一個(gè)左側(cè)頸內(nèi)動(dòng)脈串聯(lián)動(dòng)脈瘤病例和一個(gè)腦栓塞Penumbra機(jī)械取栓成功病例進(jìn)行有限元建模，并使用ANSYS14.0開(kāi)展數(shù)值模擬研究。 結(jié)果:建成了具有廣泛代表性的腦血管血壓函數(shù)模型，，以復(fù)雜顱內(nèi)動(dòng)脈瘤為例獲得了可靠的腦血管流固耦合模型的建模方法，左側(cè)頸內(nèi)動(dòng)脈串聯(lián)動(dòng)脈瘤病例和腦栓塞Penumbra機(jī)械取栓病例的數(shù)值模擬研究均取得滿意結(jié)果。 結(jié)論：聯(lián)合使用MATLAB7.0, MIMICS12.0,Geomagic Studio12,UGS NX8.0和ANSYS14.0等軟件能夠開(kāi)展常見(jiàn)腦血管病的數(shù)值模擬研究。有助于臨床醫(yī)師更加清楚認(rèn)識(shí)患者腦血管的局部流體力學(xué)特征，作為一種研究方法值得今后繼續(xù)探討。
[Abstract]:Background: cerebrovascular disease (CVD) is a common disease in the middle-aged and elderly population in China. It has been an important public health problem with the characteristics of high morbidity, high mortality and high disability rate, with the trend of rising and low age in recent years. The etiology, pathogenesis, clinical manifestation, diagnosis, differential diagnosis, treatment and prognosis of this disease have been deeply recognized in clinical medicine, but the characteristics of local cerebrovascular hydrodynamics are not clear. Influence the diagnosis and treatment of these diseases to make a deeper judgment. Computational fluid dynamics (Computational Fluid Dynamics,CFD) can accurately calculate the hydrodynamic characteristics of simulated cerebral vessels, and the images are intuitionistic and clear, which provides a great help for doctors to understand the state of cerebral blood flow. However, because of its transprofessional nature few doctors know and apply it in clinic, less research on cerebrovascular disease and less on interventional therapy of cerebrovascular disease. Objective: to explore the modeling method of regional cerebrovascular disease and develop numerical simulation to improve doctors' understanding of cerebrovascular disease. Methods: 100 elderly patients with suspected cerebrovascular disease and all cerebral angiography were selected, and blood pressure was monitored during operation. MATLAB7.0 was used to fit each monitoring curve after operation. A widely representative cerebrovascular blood pressure function model was established and 50 patients were selected to verify the reliability of the function model. Another case of giant spiral spindle-shaped aneurysm of left internal carotid artery diagnosed by whole cerebral angiography was selected, female was 67 years old, and relevant data were obtained during operation. After operation, MIMICS12.0,Geomagic Studio12 and UGS NX8.0 were used and compared with the traditional modeling methods, a reliable modeling method of cerebrovascular fluid-solid coupling model was obtained. Then the blood pressure function model and the new modeling method were used to model a case of left internal carotid artery series aneurysm and a successful case of cerebral embolism (Penumbra) mechanical thrombectomy. The numerical simulation was carried out with ANSYS14.0. Results: a widely representative cerebrovascular blood pressure function model was established, and a reliable modeling method of fluid-solid coupling model was obtained by taking complex intracranial aneurysms as an example. The numerical simulation of left internal carotid artery aneurysm and cerebral embolism (Penumbra) was satisfactory. Conclusion: the numerical simulation of common cerebrovascular diseases can be carried out by using MATLAB7.0, MIMICS12.0,Geomagic Studio12,UGS NX8.0 and ANSYS14.0 software. It is helpful for clinicians to understand more clearly the characteristics of local fluid dynamics of patients' cerebral vessels. As a method of research, it is worth further discussing in the future.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.3

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