OSAHS患者上气道流体动力学模型的建立与应用  

Establishment and application of CFD method in OSAHS patients

作　　者：陆立彦[1] 张宇宁[2] 郭宇峰[3] 陈广[1] 卢晓峰[1] 朱敏[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颅颌面科上海市口腔医学重点实验室,上海200011 [2]华威大学工程学院 [3]上海交通大学医学院附属瑞金医院耳鼻咽喉科,上海200025

出　　处：《中国口腔颌面外科杂志》2012年第5期397-402,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(08DZ2271100;074119644)

摘　　要：目的:应用计算机流体力学(computational fluid dynamics,CFD)方法建立平静呼吸下OSAHS患者上气道的有限元模型,并模拟咽腔形态及内部流动,计算平静呼吸下患者的咽腔流体流场,进行对比验证分析。方法:对志愿者(中度OSAHS患者)上气道行头影测量分析和CT扫描,通过Amira 4.0建立上气道三维模型,利用Gambit 2.3.16网格划分后,在Fluent 6.3.2下采用SIMPLIC算法模拟低流量下的咽腔内部流体力学。对CFD测量结果进行验证。结果:①实验提示,该患者上气道最狭窄处位于软腭后区,最小截面积为1.349×10-4m3,与头影测量分析及临床检查相符合;②在上气道最狭窄区域,出现上气道最大流速(14.39 m/s)、最大压降(总压降40.60%);气道顺应性增大。结论:本研究建立的CFD模型能准确反映患者上气道实际情况。在上气道狭窄区域,气道顺应性增大,更易造成气道塌陷,形成"狭窄-塌陷"的恶性循环,应及时干预,避免病情发展。PURPOSE： To evaluate the accuracy of the CFD method in the analysis of upper airway in obstructive sleep apnea hypopnea syndrome（OSAHS） patients.METHODS： One female with moderate OSAHS underwent cephalometric analysis and CT scan.The meshed model（FEM model） was built on the base of CT scans through Amira 4.0 and Gambit 2.3.16.Then the software Fluent 6.3.26 was used to stimulate the characteristics of airflow in upper airway at the breathing rate 190mL/s.The SIMPLC method was applied.The results were compared with cephalometric analysis and clinical examination.RESULTS： The minimum cross section area（1.349×10-4 m3） of upper airway was obtained by CFD model,which was matched well with the cephalometric analysis and the clinical examination.Maximum air velocity（14.39m/s） in 190mL flow and maximum pressure change（40.60%） were observed in this area.CONCLUSIONS： CFD model based on CT data enhanced our understanding of the mechanism of OSAHS.It suggested that the abnormal morphology contributed to the collapse in upper airway,leading to worse prognosis.Supported by Research Fund of Science and Technology Commission of Shanghai Municipality（08DZ2271100,074119644）.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 计算流体力学 三维重建 咽腔 

分 类 号：R766[医药卫生—耳鼻咽喉科]