胰十二指肠切除术置放胰管引流合理性的流体动力学模拟研究  

Simulated hydrodynamics study on rationality of placement of pancreatic drainage after pancreaticoduodenectomy

作　　者：姜凯[1] 陈照军[2] 陈永卫[1] 刘江[1] 赵向前[1] 苏明[1] 刘洋[1] 张文智[1] 董家鸿[1] 黄志强[1] 

机构地区：[1]解放军总医院肝胆外科,北京100853 [2]中国石油大学(华东)化学工程学院,重质油国家重点实验室,山东青岛266555

出　　处：《解放军医学杂志》2014年第3期184-187,共4页Medical Journal of Chinese People's Liberation Army

基　　金：国家科技支撑计划项目(2012BAI06B01)~~

摘　　要：目的探讨胰十二指肠切除术置放胰管引流的合理方法并对其安全性及可行性进行评价。方法通过经典伯努利（Bernoulli’sequation）管内流体流动机械能衡算式，对胰液在胰管引流管内的流动机械能进行推导计算。设定胰液流速和密度为固定值，考察影响两截面间压力差（△P）的4个关联因素；分别通过实验验证引流管内径和长度对引流速度的影响；利用自制模拟胰管引流装置，观察不同液位差对△P影响。结果推导计算数据得出，引流过程中4个因素的影响大小依次为：引流管内径〉液位差〉引流液黏度〉引流管长度。实验证实引流管长度对引流速度的影响较小，而管径影响较大；模拟胰管外引流过程验证了液位差对Ap的影响较大。结论胰管引流管内径需要1．5-2．0mm，且保持管内液体的连续性，才能保证引流管有效、通畅；体外引流管长度以1．4m为宜；胰管肠内引流可能是最佳方式。Objective To explore a rational method of placing appropriate pancreatic drainage after pancreaticoduodenectomy, and evaluate its safety and feasibility. Methods Classic Bernoulli＇s flowing mechanics energy equation （Bernoulli＇s equation） was used to calculate the dynamics of pancreatic juice flowing inside of the drainage tube. With given constant flowing velocity and density of pancreatic juice, four related factors on AP （pressure difference between entrance and exit planes of drainage tube） were investigated via rehearsing the formula. Effects on draining velocity by diameter and length of the tube were further verified by use of self-made pancreas drainage simulator, as well as the impact of liquid level difference on AP. Results Data obtained from calculation elucidated that the rank of 4 related factors was as follows： inner diameter 〉 liquid level difference 〉 liquid viscosity 〉 tube length. The experiment also verified that the influence of draining velocity depended more on diameter rather than length. Liquid level difference was identified as major independent impact factor on AP. Conclusions Tube calibre ranging 1.5-2.0mm to allow a continuity of liquid flow is an essential factor to promise a fluent drainage. A 1.4m-length drainage tube is recommended for external draining, however, irrtraintestinal drainage of the pancreatic duct may be the best option.

关 键 词：胰十二指肠切除术 胰液 引流术 

分 类 号：R657.5[医药卫生—外科学]