坐姿下不同组织压力性损伤生物力学研究  

Biomechanical Study on Pressure Injury of Different Tissues in Sitting Position

作　　者：牛斌 郑清丽 赵一凡 高翔 侯添 安美文 NIU Bin;ZHENG Qingli;ZHAO Yifan;GAO Xiang;HOU Tian;AN Meiwen(College of Biomedical Engineering,Taiyuan University of Technology,Taiyuan 030024,China)

机构地区：[1]太原理工大学,生物医学工程学院,太原030024

出　　处：《医用生物力学》2023年第6期1079-1085,共7页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(12272251,12102285);山西省青年科学研究项目(20210302124524)。

摘　　要：目的 探讨坐姿下臀部压力性损伤易发部位以及不同软组织的生物力学响应,为有效预防深层组织压力性损伤提供参考。方法 基于臀部CT扫描数据,建立坐位臀部有限元模型,包括骨骼、肌肉、脂肪和皮肤组织及坐垫模型,利用生死单元模拟组织损伤。对比实验坐垫界面压力测量数据与有限元模拟结果,验证模型有效性。模拟坐位力学状态,研究软组织的应力、应变情况,分析不同软组织中的压应力及超出极限值后可能造成的损伤情况。结果 通过对比坐垫模型仿真结果与实验界面压力测量结果,证明模型有效。坐位时坐骨结节下方软组织区域出现应力集中现象。其中,臀大肌组织中的横向压应力峰值约为38 kPa,剪切应力峰值约为3.4 MPa;而脂肪组织中的最大压应力与剪切应力峰值分别为22 kPa与4.5 MPa,均未出现在坐骨结节正下方。结论 软组织受到一定时间和大小的压力载荷作用,可能出现深层组织损伤。当保持坐姿一定时间后,应及时变换体位,以降低压力性损伤出现的概率。研究结果为预防压力性损伤提供生物力学依据,具有重要的临床研究价值。Objective To explore the prone site of pressure injuries in buttock in sitting position and the biomechanical response of different soft tissues,so as to provide references for effective prevention of deep tissue pressure injury.Methods Based on CT scan data of the buttock,the finite element model of the buttock in sitting position was established,including the bone,muscle,fat,skin tissues and cushion model.Tissue injury was simulated using life-death elements.The pressure measurement data of the experimental cushion interface were compared with the finite element simulation results to verify validity of the model.The mechanical state of the sitting position was simulated,the stress and strain of soft tissues were studied,and the compressive stress in different soft tissues and the possible damage after exceeding the limit values were analyzed.Results By comparing the simulation results of the cushion model with the experimental interface pressure measurement results,the model was proved to be effective.Stress concentration occurred in soft tissues below the ischial tuberosity in sitting position.The peak transverse compressive stress and peak shear stress in gluteus maximus were 38 kPa and 3.4 MPa,respectively.The maximum compressive stress and peak shear stress in adipose tissues were 22 kPa and 4.5 MPa,respectively,which did not appear directly below the ischial tuberosity.Conclusions Deep tissue injury may occur when soft tissues are subjected to a certain magnitude of pressure load within a certain time period.When the sitting position is maintained for a certain period of time,the position should be changed in time to reduce the probability of pressure injury.This study provides biomechanical references for the prevention of pressure injury,and has important clinical research values.

关 键 词：压力性损伤 深层组织损伤 压应力 坐姿 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]