男性尿道括约肌失协同的有限元分析  

Finite Element Analysis of Male Urethral Sphincter Loss Synergy

作　　者：王芳 孔虎 翟丽东[3] 黎鹏 周劲松 贾烁琪 樊瑜波 WANG Fang;KONG Hu;ZHAI Lidong;LI Peng;ZHOU Jinsong;JIA Shuoqi;FAN Yubo(Key Laboratory of Integrated Design and On-Line Monitoring of Light Industrial and Food Engineering Machinery and Equipment in Tianjin,College of Mechanical Engineering,Tianjin University of Science and Technology,Tianjin 300222,China;Key Laboratory of Rehabilitation Aids Technology and System of the Ministry of Civil Affairs,National Research Center for Rehabilitation Technical Aids,Beijing 100176,China;School of Basic Medicine,Medical University of Tianjin,Tianjin 300070,China;Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education,School of Biological Sciences and Medical Engineering,Beihang University,Beijing 100191,China)

机构地区：[1]天津科技大学机械工程学院,天津市轻工与食品工程机械装备集成设计与在线监控重点实验室,天津300222 [2]国家康复辅具研究中心民政部康复辅具技术与系统重点实验室,北京100176 [3]天津医科大学基础医学院,天津300070 [4]北京航空航天大学生物与医学工程学院,生物力学与力生物学教育部重点实验室,北京100191

出　　处：《医用生物力学》2022年第1期131-136,共6页Journal of Medical Biomechanics

基　　金：国家自然科学基金面上项目(12102301,31871212,51975411);天津市教委科研计划项目(2017KDYB021);天津市企业科技特派员项目(18JCTPJC57600)。

摘　　要：目的探究内外括约肌失协同对下尿路器官组织应力和尿液流速的影响。方法基于火棉胶切片对下尿路器官组织进行几何模型重建,并建立含有肌肉主动力的下尿路有限元模型;通过流固耦合仿真,模拟排尿末期内外括约肌均正常收缩、均丧失主动力和单独丧失主动力4种情况下组织应力和尿流速率变化。结果内外括约肌正常收缩尿道应力变化和临床测得的尿道压力变化趋势相同。与正常收缩情况比较,内括约肌单独丧失主动力,内括约肌和前列腺位置尿道应力分别降低33.6%、13.8%,且此位置尿液流速也降低。外括约肌单独丧失主动力,外括约肌和外尿道位置尿道应力分别降低59.5%、24.03%,而内外括约肌均丧失主动力,内括约肌、前列腺、外括约肌和外尿道位置尿道应力分别降低38.77%、18.6%、63.58%、29.74%,且相对应位置的流速也降低。结论内外括约肌失协同导致下尿路组织应力和尿液流速的差异性变化。研究结果可为手术治疗因括约肌引起的尿失禁提供理论依据。Objective To investigate the influence of internal and external sphincter loss synergy on stress distributions and urine flow rates of lower urinary tract organs and tissues.Methods Based on collodion slice,the geometric model of the lower urinary tract was reconstructed,and finite element model of the lower urinary tract with muscle active force was established.Through fluid structure coupling simulation,the changes of tissue stress and urine flow rate were simulated under four conditions:normal contraction of internal and external sphincter,total loss of muscle active force and single loss of muscle active force for internal and external sphincters at the end of urination.Results The urethral stress changes in normal contraction of internal and external sphincter muscles were the same as the clinically measured urethral pressure changes.Compared with normal contraction,when the internal sphincter lost its muscle active force alone,stress of the internal sphincter and the urethra of the prostate was reduced by 33.6%and 13.8%,and flow rate of urine in this position was also reduced.When the external sphincter lost its muscle active force alone,the urethral stress of the external sphincter and external urethra was reduced by 59.5%and 24.03%,respectively.When the internal and external sphincter lost muscle active force,stress of the internal sphincter,the prostate,the external sphincter and the external urethra were reduced by 38.77%,18.6%,63.58%,29.74%,respectively,and flow velocity in the corresponding position was also reduced.Conclusions Internal and external sphincter loss synergy resulted in the difference of tissue stress and urine flow rate.The results can provide the theoretical basis for surgical treatment of urinary incontinence caused by sphincter.

关 键 词：尿失禁 内外括约肌 尿动力学 流固耦合 

分 类 号：R318.01[医药卫生—生物医学工程]