天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (9): 1003-1005.doi: 10.11958/j.issn.0253-9896.2015.09.012

• 临床研究 • 上一篇    下一篇

单侧经肛提肌外腹会阴联合切除术对盆底影响的有限元分析

王捷夫1,柳建中2   

  1. 1. 天津医科大学肿瘤医院；国家肿瘤临床医学研究中心；天津市“肿瘤防治”重点实验室
    2. 天津市肿瘤医院
  • 收稿日期:2014-12-01 修回日期:2015-05-20 出版日期:2015-09-15 发布日期:2015-09-15
  • 通讯作者: 柳建中 E-mail:vonjeff@sina.com
  • 作者简介:王捷夫 （1987）， 男， 博士， 主要从事结直肠肿瘤及盆底生物力学方面研究

Finite element analysis of the effect of unilateral extralevator abdominal-perineal excision on the pelvic floor

Jie-Fu WANG,Jian-Zhong Liu   

  1. Department of Colorectal Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research
  • Received:2014-12-01 Revised:2015-05-20 Published:2015-09-15 Online:2015-09-15
  • Contact: Jian-Zhong Liu E-mail:vonjeff@sina.com

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摘要： 目的 应用有限元分析方法比较单侧经肛提肌外腹会阴联合切除术 （ELAPE） 和 ELAPE 手术对于盆底生物力学影响的差异。方法 建立女性盆底的 3 种有限元分析模型： 正常模型， ELAPE 模型和单侧 （右） ELAPE 模型，测量 3 种模型在相同载荷作用下的各组织最大应力， 并观察应力分布。结果 在肛提肌保留侧， 单侧 ELAPE 模型非肛提肌组织内的最大应力低于 ELAPE 模型， 而与正常模型比较差异无统计学意义； 在肛提肌切除侧， 其最大应力也低于 ELAPE 模型， 但高于正常模型； 其肛提肌保留侧的整体应力低于切除侧。结论 相比于 ELAPE 手术， 单侧 ELAPE 手术可降低盆底双侧的非肛提肌组织内的应力， 在肛提肌保留侧更为明显。

关键词: 腹部, 会阴, 骨盆底, 生物力学, 有限元分析, ELAPE 手术

Abstract: Abstract: Objective To evaluate the effects of unilateral extralevator abdominal-perineal excision (ELAPE) surgery and the ELAPE surgery on the pelvic floor detected by finite element analysis. Methods Three kinds of finite element mod⁃ el were developed: the intact model, ELAPE model and the unilateral ELAPE model. The maximal stress and stress distribu⁃ tions of each model under the same pressure were analyzed and compared. Results In the unilateral ELAPE model, non-le⁃ vator ani tissue’ s maximal stress on the levator ani reserved side was lower than that in ELAPE model, and was similar to that in the intact model. Its maximal stress on the excised side was lower than that in ELAPE model, and which was higher than that of intact model. Its maximal stress on the reserved side was lower than that of on the excised side. Conclusion Compared to the ELAPE surgery, the unilateral ELAPE surgery is able to reduce the stress of non-levator ani tissue on both sides, especially on the levator ani reserved side.

Key words: abdomen, perineum, pelvic floor, biomechanics, finite element analysis, ELAPE surgery