辅助仰卧位侧翻过程压疮易发部位的生物力学建模与实验研究  

Biomechanical Modeling and Experimental Study on the Common Sites of Pressure Ulcers in the Process of Assisted Turning over from Supine Position

作　　者：伦庆龙 苏鹏 卢达 李硕 李剑 Lun Qinglong;Su Peng;Lu Da;Li Shuo;Li Jian(School of Electromechanical Engineering,Beijing Information,Science and Technology University,Beijing 100192,China;School of Biological and Medical Engineering,Beihang University,Beijing 100191,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)

机构地区：[1]北京信息科技大学机电工程学院,北京100192 [2]北京航空航天大学生物与医学工程学院,北京100191 [3]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

出　　处：《中国生物医学工程学报》2022年第3期310-319,共10页Chinese Journal of Biomedical Engineering

基　　金：国家自然科学基金(52005045);北京市自然科学基金(19L2018);北京市教委科研计划科技一般项目(KM202011232009)。

摘　　要：压疮是局部组织长期受压而致组织溃烂和坏死的一种病症。通过仰卧位侧翻缓解局部压力是长期卧床患者预防压疮病症发生的有效措施之一,所以研究辅助侧翻过程中压疮典型部位的生物力学意义重大。基于解剖学理论,利用CT图像数据建立躯干部压疮易发部位的骨骼与软组织有限元模型,研究不同侧翻角度下躯干部压疮易发部位的最大应力情况,并通过美国TEKSCAN公司的压力分布测试系统对10名志愿者进行人体仰卧位侧翻实验,验证仿真分析的正确性。结果表明,在侧翻过程中人体同一部位所受的压力是不同的,在90°位置出现了应力峰值的极值点,产生了应力集中现象;在角度阈值30°~45°范围内肩部和臀部各部位应力峰值比较均衡,均在0.035~0.070 MPa,表明在此阈值内人体与辅助面多部位接触,应力较为分散,两者之间存在一个使多个压疮易发部位受压最优的接触形式。研究展示了躯干部压疮易发部位在辅助仰卧位侧翻过程中的受压变化情况,相关结果有益于仰卧位侧翻辅助器械的设计与使用,并为临床护理提供参考。A pressure ulcer is a condition in which the long-term pressure on local tissues leads to tissue ulceration and necrosis. Relief of local pressure through supine lateral rotation is one of the effective measures to prevent the development of pressure ulcers in long-term bedridden patients, so it is significant to study the biomechanics of the typical site of pressure ulcers during assisted lateral rotation. Based on anatomical theory, a finite element model of the bones and soft tissues of the pressure ulcer-prone areas of the trunk was established using CT image data to study the maximum stresses on the pressure ulcer-prone areas of the trunk at different lateral turning angles, and a human supine lateral turning experiment was conducted on 10 volunteers using the TEKSCAN pressure distribution test system to verify the correctness of the simulation analysis. Results showed that the stresses on the same part of the body were different during the rollover process, with extreme points of stress peaks at 90° position, producing a stress concentration phenomenon. The peak stresses at each part of the shoulder and hip were relatively evenly balanced within the angular threshold range of 30° to 45°, both at 0.035~0.070 MPa, indicating that the body was in contact with multiple parts of the auxiliary surface within this threshold and that the stresses are more dispersed, with a form of contact between the two that optimized pressure on multiple pressure ulcer prone areas. This study demonstrated the changes in pressure on pressure-prone areas of the trunk during assisted supine lateral rotation, and the obtained results would be useful for the design and use of supine lateral rotation aids and as a reference for clinical care.

关 键 词：侧翻 压疮 翻身床 生物力学 接触压强 

分 类 号：R3188[医药卫生—生物医学工程]