不同破口大小对B型主动脉夹层假腔内压力的影响

为了研究夹层内的血流动力学变化对夹层转归的重要影响,并期望为临床判断主动脉夹层发展及转归提供理论依据,通过3D打印技术制作不同出入口比例及破口大小的B型主动脉夹层模型,对主动脉夹层内血流变化进行模拟,并测量观察主动脉夹层模型假腔内压力变化及流场情况.真腔内固定压力为18.620、21.280 k Pa两组中,不同破口比例的假腔入口压力比普遍均小于夹层模型内其他假腔位置,且压力值低于真腔压力;真腔内压力为23.940 k Pa组中,破口比例为2∶1的夹层模型内假腔压力比较其他破口比例模型的压力比明显升高;所有模型真腔固定水压为21.280、23.940 k Pa下均可观测到同真腔压力下,真腔流速更快,其内部压力低于假腔.同一模型中,假腔压力普遍低于真腔压力;相同压力下,原发破口大的模型假腔流速相对较低,而涡流明显;相同模型相同压力下,假腔流速低于真腔,假腔的涡流更为明显,复杂的涡流和旋动对壁面造成冲击进而使假腔破裂风险增加.

Effect of Stanford Type-B Aortic Dissection With Different Tear Sizes on the False Lumen Pressure

To study the important influence of interlining on the outcome and provide the theory basis for development of aortic dissection and outcomefor clinical judgment,a model of type-B aortic dissection with different proportions of entrance and export and size of the crevasse by 3D printing was made to simulate the blood flow change and the measure model of aortic dissection false lumen flow field and pressure change. When the true lumen pressure was fixed at 18. 620 kPa and 21. 280 kPa, different proportions of breach of the false lumen inlet pressure were generally less than other false lumen locations, and the pressure in the false lumen was lower than the true lumen. When the true lumen pressure was fixed at 23. 940 kPa, and the crevasse ratio was 2:1,the false lumen pressure on the model compared with other breach scale increased significantly. All true lumen fixed models under the pressure of 21. 280 kPa and 23. 940 kPa can be observed that with the same lumen pressure, true lumen flow faster, whose internal pressure was lower than the false lumen. In the same model, the false lumen pressure was generally lower than true lumen pressure. With the same pressure, the false lumen flow rate of the primary break big model was relatively low, the eddy current was obvious. In the same model, with the same pressure, the false lumen flowed lower than the true lumen, the eddy current of false lumen was more apparent, and the complex vortex and the twisting made shock on the cavity wall increasing the risk of fracture.