颌面部爆炸伤造成颅底继发损伤三维有限元仿真模拟及生物力学分析  

Three-dimensional finite element simulation and biomechanical analysis of maxillofacial blast injuries and secondary injuries to the skull base

作　　者：周旭华 朱勋志 欧阳荣建 曾勇 张纲 谭颖徽 OU Xuhua;ZHU Xunzhi;OUYANG Rongjian;ZENG Yong;ZHANG Gang;TAN Yinghui(Department of Oral and Maxillofacial Surgery,Second Affiliated Hospital,Army Medical University (Third Military Medical University),Chongqing,400037;Troop 31640 of Chinese PLA,Wenshan,Yunnan Province,663600,China)

机构地区：[1]陆军军医大学(第三军医大学)第二附属医院口腔科 [2]中国人民解放军31640部队

出　　处：《第三军医大学学报》2019年第4期308-314,共7页Journal of Third Military Medical University

基　　金：军队"十二五"第二批重点项目(BGZ1500J001)~~

摘　　要：目的利用有限元法(finite element method,FEM)构建人颌面部三维有限元模型,仿真模拟颌面部不同部位爆炸伤,对颅底部继发性损伤进行生物力学分析。方法采集一成年男性头部CT数据,用有限元建模软件建立人颌面骨三维有限元模型;在爆炸当量、距离相同条件下,对颌面部不同部位爆炸伤进行动态仿真模拟;在颅底部选取15个标志点进行生物力学分析。结果成功模拟出颌面部3个部位受到相同条件冲击波作用时,颌面骨骨折的动态过程、颅底部应力分布及传导情况;爆炸物距鼻尖前方5 cm时,卵圆孔内侧、垂体窝、斜坡等Von Mises应力较大;爆炸物距右眼眶下缘正前方5 cm时,卵圆孔内侧、垂体窝、斜坡等Von Mises应力较大;爆炸物距右侧颧弓正前方5 cm时,右侧蝶骨大翼、右侧卵圆孔内侧、斜坡等Von Mises应力较大。结论利用FEM可以有效地模拟颌面部爆炸伤的致伤过程,颌面部不同部位受到爆炸冲击波时,应力集中区出现的部位不仅与颅底结构有关,也与应力传导途径有关。Objective To construct a three-dimensional finite element model of human maxillofacial structures to dynamically simulate blast injuries in different maxillofacial regions and analyze the biomechanical characteristics of skull base injuries caused by maxillofacial blast injuries.Methods The head CT data were acquired from a normal male adult and a three-dimensional finite element model of the maxillofacial bones was constructed using finite element modeling software.Using the same parameters of blast yield and distance,we dynamically simulated blast injuries in different maxillofacial regions on this model and analyzed the biomechanical data at 15 selected landmarks in the skull base.Results We successfully simulated the dynamic process of maxillofacial fractures and stress distribution and conduction in the skull base using the constructed model.In the events of an explosion at precisely 5 cm from the front of the nasal bone tip and one at 5 cm from the front of the edge of the right orbit,the stress values of Von Mises at the medial foramen ovale,hypophyseal fossa,clivus and posterior wall of the foramen magnum were greater than those at the other landmarks;when the explosion occurred at 5 cm from the front of the right zygomatic arch,the right greater wing of the sphenoid bone,right medial foramen ovale,hypophyseal fossa,clivus and posterior wall of the foramen magnum sustained greater stress values of Von Mises.Conclusion Finite element modeling is capable of simulating the process of maxillofacial blast injuries.Blast wave impact in different maxillofacial regions results in stress concentration in different areas in relation not only to the structure of skull base but also to the stress conduction pathway.

关 键 词：爆炸伤 颌面部 有限元法 颅底损伤 生物力学 

分 类 号：R319[医药卫生—基础医学] R642