瘢痕子宫破裂影响因素的有限元分析  

Influencing factors of rupture of scar uterus based on finite element method

作　　者：孟颜颜 贺磊[1] 马新刚[2] 董瑞春 王贤达 MENG Yanyan;HE Lei;MA Xingang;DONG Ruichun;WANG Xianda(School of Mechanical Engineering, Shandong University of Technology, Zibo, Shandong 255000;Department of Surgical Anaesthesia, Zibo Maternal and Child Health Hospital, Zibo, Shandong 255000)

机构地区：[1]山东理工大学机械工程学院,山东淄博255000 [2]淄博市妇幼保健院手术麻醉科,山东淄博255000

出　　处：《暨南大学学报（自然科学与医学版）》2018年第6期505-511,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：山东省重点研发计划公益类项目(2017GGX203004);淄博市科技发展计划项目(2016kj010029)

摘　　要：目的:以往对瘢痕子宫能否经阴分娩的研究主要是通过超声评估.本研究应用有限元法分析瘢痕厚度、瘢痕长度和材料特性对瘢痕子宫受力的影响,探讨瘢痕子宫经阴分娩时的破裂预警.方法:应用SOLIDWORKS建立足月瘢痕子宫的三维模型,对该模型进行ANSYS仿真分析并验证.结果:在宫缩过程中,厚度越小瘢痕处应力越大越易破裂;以3 mm作为子宫前壁厚度的边界值,若测量厚度大于界值可以考虑经阴分娩,反之易发生子宫破裂应选择剖宫产;在施加同一内压下,瘢痕越长,瘢痕所受应力越大,子宫越易破裂;杨氏模量太小或者太大,都导致瘢痕所受应力增大.结论:经敏感性分析得出瘢痕厚度对子宫破裂影响最大,瘢痕长度和材料特性影响较小.基于ANSYS仿真分析以一种新的角度研究了瘢痕子宫破裂的影响因素,为瘢痕子宫能否选择经阴分娩提供客观分析方法和临床指导.Objective: In the past studies whether or not the vaginal delivery can be selected in the scar uterus were mainly through ultrasound assessment. In this paper, the finite element methodshould be used to analyze the influence of scar thickness, scar length andmaterial characteristics on the force of scar uterus, and to explore thecracking precautions of scaruterus during vaginal delivery. Methods: A three-dimensional model of full-term uterus was established with SOLIDWORKS. Then ANSYS simulation analysis of the model was carried out and verified. Results: The smaller the thickness, the greater the stress at the scar, the more easily to crack; 3 mm as the boundary value of thickness of uterine anterior wall. It can be considered in vaginal delivery if the measured thickness was greater than the boundary value, instead uterine tend to rupture and cesarean section should be chosen; The longer the scar, the greater the stress of scar, and the uterus was more likely to rupture under the same internal pressure; If young s modulus is too small or too large, it will lead to increased stress on the scar. Conclusion: Scar thickness has the greatest impact on uterine rupture, and length and material properties have less effect. Based on ANSYS simulation analysis, studying the influencing factors of scar uterine rupture in a new perspective, and providing objective analysis methods and clinical guidance for the choice of vaginal delivery for scar uterus.

关 键 词：瘢痕子宫破裂预警 瘢痕厚度 瘢痕长度 杨氏模量 有限元分析 

分 类 号：R719.82[医药卫生—妇产科学]