前臂桡侧皮瓣血流动力学模型的建立  

Establishment of hemodynamic model of human radial forearm free flap

作　　者：徐立群[1] 范秦寅[2] 张宝亮[3] 张华[1] 张陈平[1] 胡广洪[3] 

机构地区：[1]上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面外科,上海市口腔医学重点实验室,上海200011 [2]日本大阪大学大学院工学研究科,大阪564005 [3]上海交通大学塑性成形系,上海200030

出　　处：《上海口腔医学》2011年第2期136-140,共5页Shanghai Journal of Stomatology

基　　金：上海交通大学医工交叉课题(YG2009MS41)~~

摘　　要：目的:建立以桡动静脉为血管蒂的前臂皮瓣血流动力学三维数值模型,并探讨其科学有效性。方法:应用Pro/E(Wildfire 4.0)软件建立前臂皮瓣三维几何模型。椭圆形皮瓣的长短轴分别为80mm×50mm,厚度为10mm,血管蒂(桡动脉内径1.9mm,桡静脉内径0.84mm)长50mm,以半嵌入方式平行长轴贯穿皮瓣。将几何模型整体导入SC/Tetra 8.0软件,进行网格划分和计算。根据实测桡动脉流量,设定进口血液流速为20mm/s,参照皮瓣血管蒂实测压力差53mmHg,初步获得压力损失模型(porous model)的有关系数值,然后将压力损失模型代入皮瓣,模拟毛细血管网对血流的阻力,计算出皮瓣及血管蒂部的血液流动,比较分析血管蒂部桡、动静脉中心轴向压力分布和不同截面径向血液流速分布。结果:前臂皮瓣模型的整体网格数为10355473,节点数为2104014。皮瓣代入压力损失模型后,桡、动静脉出入口压力差值为7050Pa(52.8mmHg),接近临床实测值。计算流体力学分析显示,在压力损失模型中桡动脉的中心轴向压力分布持续维持在较高的水平,当血液流入及流出皮瓣时,会出现速度减缓和增加,而桡静脉的中心轴向压力值在血液流出皮瓣的瞬间急剧下降,结果特征符合皮瓣血液正常生理循环特点。结论:压力损失模型能够较合理有效地模拟前臂桡侧皮瓣的血流动力学特点。本研究提出了皮瓣血流机制研究的新方法,为进一步血管吻合口流场变化的研究奠定了基础。PURPOSE： To preliminarily establish a hemodynamic 3D numeric model of radial forearm free flap with vascular pedicle of radial artery and vein,and discuss its scientific workability.METHODS： The 3D geometric model of 50mm×80mm×10mm radial forearm flap was established by Pro/E（Wildfire 4.0）.The vascular pedicle was 50mm in length including radial artery（inside diameter was 1.9mm） and concomitant radial vein（inside diameter was 0.84mm）.The half-embedded vessels went through the flap paralleling the long axis.Then the established geometric model was transferred to the SC/Tetra 8.0 software for mesh generation and calculation.According to the virtual flow volume of the radial artery,the inlet velocity was set as 20mm/s.With the different blood pressure of 53mmHg between the feeding artery and draining vein,the tentative porous values were achieved.Then porous model was applied to the flap to simulate the capillary structure.The pressure distribution on the central axis of radial artery and vein and the radial velocity distribution in three different cross sections of vessels were figured out.RESULTS： A model with 10355473 meshes and 2104014 nodes was built.When porous model was applied,the pressure difference between radial artery and vein was calculated to 7050 Pa（52.8mmHg）,which was close to clinical value.The computational fluid dynamic analysis results showed that with porous model,the central pressure of radial artery was continuously kept to a higher level.When blood flowed in and flows out of the flap,the blood velocity decreased and increased greatly.While the central pressure of radial vein significantly decreased at the moment of blood flowing out of the flap.These results basically agreed with the features of normal blood circulation of the forearm flap.CONCLUSIONS： Porous model effectively simulates hemodynamic status of forearm flap,which provides a new method for the study of mechanism of blood circulation in radial forearm flap and also lays a foundation for the following hemo

关 键 词：前臂桡侧皮瓣 桡动脉 桡静脉 计算流体力学 压力损失模型 

分 类 号：R318.0[医药卫生—生物医学工程]