单侧经肛提肌外腹会阴联合切除术对盆底影响的有限元分析  

Finite element analysis of the effect of unilateral extralevator abdominal-perineal excision on the pelvic floor

作　　者：王捷夫[1] 柳建中[1] 

机构地区：[1]天津医科大学肿瘤医院结直肠肿瘤科,国家肿瘤临床医学研究中心,天津市"肿瘤防治"重点实验室,300060

出　　处：《天津医药》2015年第9期1003-1005,I0006,共4页Tianjin Medical Journal

摘　　要：目的应用有限元分析方法比较单侧经肛提肌外腹会阴联合切除术(ELAPE)和ELAPE手术对于盆底生物力学影响的差异。方法建立女性盆底的3种有限元分析模型:正常模型,ELAPE模型和单侧(右)ELAPE模型,测量3种模型在相同载荷作用下的各组织最大应力,并观察应力分布。结果在肛提肌保留侧,单侧ELAPE模型非肛提肌组织内的最大应力低于ELAPE模型,而与正常模型比较差异无统计学意义;在肛提肌切除侧,其最大应力也低于ELAPE模型,但高于正常模型;其肛提肌保留侧的整体应力低于切除侧。结论相比于ELAPE手术,单侧ELAPE手术可降低盆底双侧的非肛提肌组织内的应力,在肛提肌保留侧更为明显。Objective To evaluate the effects of unilateral extralevator abdominal-perineal excision （ELAPE） surgery and the ELAPE surgery on the pelvic floor detected by finite element analysis. Methods Three kinds of finite element model were developed：the intact model, ELAPE model and the unilateral ELAPE model. The maximal stress and stress distributions of each model under the same pressure were analyzed and compared. Results In the unilateral ELAPE model, non-levator ani tissue’s maximal stress on the levator ani reserved side was lower than that in ELAPE model, and was similar to that in the intact model. Its maximal stress on the excised side was lower than that in ELAPE model, and which was higher than that of intact model. Its maximal stress on the reserved side was lower than that of on the excised side. Conclusion Compared to the ELAPE surgery, the unilateral ELAPE surgery is able to reduce the stress of non-levator ani tissue on both sides, especially on the levator ani reserved side.

关 键 词：腹部 会阴 骨盆底 生物力学 有限元分析 ELAPE手术 

分 类 号：R615[医药卫生—外科学]