中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (4): 459-464.doi: 10.13418/j.issn.1001-165x.2023.4.15

• 临床生物力学 • 上一篇    下一篇

突入膀胱不同形态的前列腺增生的有限元分析

洪丽婷1,    孟庆国1,    吴建辉2,    徐凌雁3,    高润泽1,    翟丽东1*   

  1. 1.天津医科大学基础医学院人体解剖与组织胚胎学系,  天津   300070;    2.天津市第一中心医院, 天津  300190;
    3.中国铁路设计集团有限公司,  天津    300308
  • 收稿日期:2022-12-05 出版日期:2023-07-25 发布日期:2023-08-02
  • 通讯作者: 翟丽东,教授,E-mail:zhailidong2005@126.com
  • 作者简介:洪丽婷(1997-),女,江西人,硕士在读,研究方向:生物力学仿真,E-mail:hongliting130@163.com
  • 基金资助:
    国家自然科学基金资助项目(31871212)

Finite element analysis of different forms of intravesical prostatic protrusion

Hong Liting 1, Meng Qingguo 1, Wu Jianhui 2, Xu Lingyan 3, Gao Runze 1, Zhai Lidong 1*   

  1. 1. Department of Anatomy and Histology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070; 2. Department of Urology, Tianjin First Central Hospital, Tianjin 300190; 3. China Railway Design Corporation, Tianjin 300308
  • Received:2022-12-05 Online:2023-07-25 Published:2023-08-02

摘要: 目的    通过有限元分析方法,探索不同形态的膀胱内前列腺突出(intravesical prostatic protrusion,IPP)对排尿过程的影响。  方法    基于1例前列腺中叶和双侧叶突入膀胱的良性前列腺增生患者MRI图像,重建其下尿路有限元模型(模型3)。通过图像修改突出部分,构建双侧叶突出模型(模型1)和中叶突出模型(模型2)。结合有限元分析软件进行双向流固耦合仿真分析,比较3种模型的前列腺尿道形变和流体动力学参数。  结果    排尿过程中,模型3前列腺尿道角减小的程度最大,其次是模型2。模型3中的液体压强损失最严重。在每种膀胱内压下,模型1的流体速度大于其他模型,模型3的最大流率低于其他模型。在相同的膀胱出口截面积,模型3的最大流率低于其他模型,且增加膀胱出口截面积会进一步扩大这一差距。  结论   与具有相同IPP长度但只有中叶突出或只有双侧叶突出的患者相比,中叶和双侧叶均突出的患者具有更大的尿道阻力和更小的最大尿流率。评估IPP不仅要测量其长度,还要注意IPP形态。

关键词: 良性前列腺增生,  ,  , 膀胱内前列腺突出,  ,  , 有限元分析,  ,  , 流固耦合

Abstract: Objective     To explore the effect of intravesical prostatic protrusion with different forms on urination by the finite element analysis method.    Methods    The finite element models for male lower urinary tract was reconstructed based on MRI images of a patient with middle lobe and bilateral lateral lobes protrusion into the bladder model 3. Other models with only the bilateral lateral protrusion and only the middle lobe protrusion were created by adjusting the shape of the protruded part. The two-way fluid-structure interaction of the lower urinary tract was simulated by the finite element analysis software. The deformation of prostatic urethra and flow dynamics parameters were compared between models with different IPP shapes. Results     The largest reduction of prostatic urethra angle was found in model 3 during  urination, followed by model 2 and model 1. The liquid pressure loss was most severe in model 3. The velocity in majority part of model 1 was higher than that of other two models. The maximum flow rate of model 3 was lower than that of other two models. Under the same bladder outlet cross-sectional area, the maximum flow rate of model 3 was lower than that of other models, and increasing bladder outlet cross-sectional area would further widen this gap.    Conclusions    This study reveals that patients with middle lobe and bilateral lateral lobes protrusion have greater urethral resistance and smaller maximum flow rate than those having comparable-length IPP with only middle lobe protrusion or only bilateral lateral lobes protrusion. When evaluating IPP, we should measure its length, as well pay attention to its form.

Key words: Benign prostatic hyperplasia,  ,  , Intravesical prostatic protrusion,  ,  , Finite element analysis, Fluid-structure interaction

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