CAJ | 학술논문

目的：运用有限元分析的方法，对单侧唇裂鼻畸形患者鼻部进行全面的生物力学分析和研究，从生物力学角度阐述唇裂鼻畸形形成的原因，揭示单侧唇裂鼻畸形形成的力学规律，为单侧唇裂鼻畸形患者的整形外科治疗奠定生物力学理论基础。方法自2007年至2009年，共采集单侧唇裂鼻畸形患者10例，均在术前行CT和MRI扫描，MIM-ICS软件进行计算机三维重建，建立畸形鼻部三维有限元分析模型，确定有限元分析的边界条件，进行单侧唇裂鼻畸形的鼻部生物力学的测量和分析。结果成功获得单侧唇裂鼻畸形患者的鼻部三维重建模型。分析表明，静态下，畸形鼻部的应力分布值很小，关键应力点的应力分别为鼻中隔部0.00935±0.002 MPa，鼻小柱底部0.0059±0.0021 MPa，鼻翼外侧脚0.00681±0.0013 MPa；位移载荷状态下，形变后的畸形鼻部拥有较大的应力分布值，关键应力点的应力分别为鼻小柱患侧25.51±3.98 MPa，鼻中隔部7.882±1.35 MPa，患侧鼻翼8.184±1.58 MPa。结论鼻小柱患侧是畸形整复的力学关键部位，其次是患侧塌陷鼻翼；鼻中隔应力的集中，提示了鼻中隔部位整复的重要性，其整复和固定可能是单侧唇裂鼻畸形整复的重要内容。
목적：운용유한원분석적방법，대단측진렬비기형환자비부진행전면적생물역학분석화연구，종생물역학각도천술진렬비기형형성적원인，게시단측진렬비기형형성적역학규률，위단측진렬비기형환자적정형외과치료전정생물역학이론기출。방법자2007년지2009년，공채집단측진렬비기형환자10례，균재술전행CT화MRI소묘，MIM-ICS연건진행계산궤삼유중건，건립기형비부삼유유한원분석모형，학정유한원분석적변계조건，진행단측진렬비기형적비부생물역학적측량화분석。결과성공획득단측진렬비기형환자적비부삼유중건모형。분석표명，정태하，기형비부적응력분포치흔소，관건응력점적응력분별위비중격부0.00935±0.002 MPa，비소주저부0.0059±0.0021 MPa，비익외측각0.00681±0.0013 MPa；위이재하상태하，형변후적기형비부옹유교대적응력분포치，관건응력점적응력분별위비소주환측25.51±3.98 MPa，비중격부7.882±1.35 MPa，환측비익8.184±1.58 MPa。결론비소주환측시기형정복적역학관건부위，기차시환측탑함비익；비중격응력적집중，제시료비중격부위정복적중요성，기정복화고정가능시단측진렬비기형정복적중요내용。
Objective To explore the cause and to reveal the biomechanical regularity of nasal deformation in patients with unilateral cleft lip through the biomechanical analysis on nasal deformation by finite element method, in order to establish a good biomechanical theoretical basis for treating nasal deformation of unilateral cleft lip. Methods From 2007 to 2009, 10 cases of unilateral cleft lip with nasal deformation were collected. All the cases were scanned by CT and MRI preoperatively, image data were collected and the three-dimensional nasal deformation were reconstructed by the software MIMICS. Then the finite element models of nasal deformation in unilateral cleft lip were established and the model's constraint conditions were defined for the biomechanical measurement and analysis of nasal deformation in unilateral cleft lip. Results The three-dimensional model of nasal deformation in unilateral cleft lip were reconstructed successfully. The biomechanical analysis showed that, under the static state, nasal deformation had a very small value of stress distribution. The value of the key stress points were as follows:nasal septum 0.009 35 ±0.002 MPa, the bottom of nasal columella 0.005 9 ±0.002 1 MPa, lateral feet of nasal alar 0.006 81±0.001 3 MPa;Under displacement load status, the deformed nasal had a large value of the stress distribution. The value of the key stress points were as follows:ipsilateral nasal columella 25.51 ±3.98 MPa, nasal septum 7.882 ±1.35 MPa, ipsilateral nasal alar 8.184 ±1.58 MPa. Conclusion Affected side of nasal columella is the key mechanical part to rectify deformed nose, and the following part is ipsilateral nasal alar; The stress concentration of nasal septum suggests that the rectification of nasal septum is very important, its rectification and fixation are perhaps the important contents of deformed nose rectification.