不同破口位置对主动脉夹层真假腔内压力及肾肠灌注的影响

Effects of Different Positions of Break on the True and False Lumen Pressure and Renal Perfusion of Aortic Dissection Intestinal

为提高主动脉夹层疾病的治疗效果,针对主动脉夹层疾病,研究主动脉夹层内的血流动力学变化,尤其是不同破口位置下,夹层患者的肾肠等器官的灌注情况及产生的影响.利用3D打印技术制作不同破口位置的主动脉夹层模型,通过实验方法进行主动脉夹层内血流模拟,并对主动脉夹层模型真假腔内的压力及肾肠支脉的压力进行测量,辅以超声技术进行观测.不同破口位置下,真假腔压力都会随不同基准压力(15 960、21 280、26 600 Pa)的升高而增大,在3种基准压力水平(15 960、21 280、26 600 Pa)下,模型B肠系膜动脉压力明显高于模型A肠系膜动脉压力.真假腔压力会随不同基准压力的升高而增大,压力极差变化更加剧烈,管壁的负担加重,夹层破裂风险更大.降压手段支持下,模型B有可能出现肠器官灌注不良状态,即因低灌出现脏器缺血情况.

In order to improve the therapeutic effect of aortic dissection, the aim of this study was to investigate the hemodynamic changes and the impact in the aortic dissection,especially in different sites of the aortic dissection. In the study, a model of aortic dissection was made by using 3 D printing technique. Then,the aortic dissection was simulated by different methods,and the pressure of the renal branch in the aortic dissection was measured. The true and false pressure increased with the increase of different reference pressure （15 960,21 280,26 600 P a ） ,and at the three basic pressure levels （15 960,21 280,26 600 Pa）, the Model B mesenteric arterial pressure was higher than the model A mesenteric artery pressure. The pressure of true and false lumen increased with the increase of different reference pressure,and the change of pressure difference was more intense. The burden of wall became heavier,and the risk of dissection was greater. If the blood pressure decreases,the model B group may appear that the intestinal organ perfusion status is not enough, and then cause hypoperfusion organ ischemia.