环缩宽度对肺动脉血流动力学影响  

Hemodynamic Effects of Banding Width on Pulmonary Artery

作　　者：罗苇如 熊吉文 仝志荣 余平平 孙彦隽[1] 刘金龙 LUO Weiru;XIONG Jiwen;TONG Zhirong;YU Pingping;SUN Yanjun;LIU Jinlong(Department of Cardiothoracic Surgery,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Institute of Pediatric Translational Medicine,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Shanghai Engineering Research Center of Virtual Reality of Structural Heart Disease,Shanghai Children’s Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心心胸外科,上海200127 [2]上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所,上海200127 [3]上海交通大学医学院附属上海儿童医学中心、上海结构性心脏病虚拟现实工程技术研究中心,上海200127

出　　处：《医用生物力学》2023年第3期493-499,共7页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(81970439,81870238);上海市科委科技基金项目(17DZ2253100);2020年度上海市人才发展资金(2020114)。

摘　　要：目的通过构建不同环缩宽度的肺动脉环缩术(pulmonary artery banding,PAB)模型,探索环缩宽度对肺动脉血流动力学特性改变的影响。方法保持环缩位置及程度一致,利用计算机辅助设计(computer-aided design,CAD)重构术中常用不同环缩宽度(2、3、4、5 mm)三维肺动脉模型,通过计算流体动力学(computational fluid dynamics,CFD)模拟分析压力、流线、能量损失、能量效率及肺动脉血流量分配比等,比较不同环缩宽度的PAB模型血流动力学参数。结果肺动脉环缩后压力明显下降,但环缩宽度改变对环缩处压力下降程度的影响并不显著。随着环缩宽度增加,肺动脉能量损失减少,能量效率呈上升趋势,左肺动脉血流量增加,左右肺血流分配比增大,最大可达2.28∶1。结论环缩宽度增加可减少肺动脉能量损失,提高血流能量效率,但会导致左右肺血流分配不平衡。PAB环缩宽度的选择应同时兼顾左右肺血流分配平衡和能量损失。基于CAD和CFD的PAB手术虚拟设计,可为未来个体化PAB环缩宽度选择提供帮助。Objective To investigate the effects of banding width on hemodynamic characteristics of pulmonary artery(PA)by constructing pulmonary artery banding(PAB)models with different widths.Methods Based on clinical practice,with the same banding position and degree,computer-aided design(CAD)was utilized to reconstruct three-dimensional PAB models with different banding widths(2,3,4,5 mm).Hemodynamic characteristics of the models with different banding widths,including pressure,streamlines,energy loss,energy efficiency and blood flow distribution ratio,were compared and analyzed through computational fluid dynamics(CFD).Results The pressure of PA decreased significantly,while the change of banding width had no significant effects on the pressure drop level at banding position.With the increase of banding width,the energy loss decreased,and the energy efficiency showed an upward trend.The blood flow of the left PA increased,and the ratio of blood flow distribution between the left PA and right PA increased,with the maximum reaching up to 2.28∶1.Conclusions The increase of banding width can reduce the energy loss of PA and improve the energy efficiency of blood flow,but it will lead to the imbalance of blood flow distributions between the left and right lungs.Both the balance of blood flow distribution and the energy loss should be considered in choice for banding width of PAB.The virtual design of PAB surgery based on CAD and CFD will assist individualized banding width selection in future.

关 键 词：肺动脉环缩术 环缩宽度 血流动力学 计算流体动力学 计算机辅助设计 

分 类 号：R318.01[医药卫生—生物医学工程]