CAJ | 학술논문

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。
목적：응용유한원분석방법비교단측경항제기외복회음연합절제술（ELAPE）화ELAPE수술대우분저생물역학영향적차이。방법건립녀성분저적3충유한원분석모형：정상모형，ELAPE모형화단측（우）ELAPE모형，측량3충모형재상동재하작용하적각조직최대응력，병관찰응력분포。결과재항제기보류측，단측ELAPE모형비항제기조직내적최대응력저우ELAPE모형，이여정상모형비교차이무통계학의의；재항제기절제측，기최대응력야저우ELAPE모형，단고우정상모형；기항제기보류측적정체응력저우절제측。결론상비우ELAPE수술，단측ELAPE수술가강저분저쌍측적비항제기조직내적응력，재항제기보류측경위명현。
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.