典型男性OSAHS患者上气道气流运动特性的数值模拟
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国家自然科学基金资助项目 (10972093)


Numerical simulation on the flow characteristics of upper airway in a representative male OSAHS patient
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    摘要:

    目的 研究典型男性阻塞性睡眠呼吸暂停低通气综合症(OSAHS)患者在平静呼吸时上气道气流运动特性,以及气流对软腭和悬雍垂作用的动力特点。方法 基于患者CT影像数据建立可靠的上气道流场几何模型,以临床睡眠监测数据作为数值模拟边界条件的依据,采用低雷诺数的湍流模型计算获得一个完整呼吸周期内上气道气流运动规律。结果OSAHS患者在呼吸过程中,上气道气流流动形式有显著差异。在吸气阶段,上气道腔内流速可达9.808 m/s,最大负压可达-78.856 Pa,鼻腔顶部出现局部回流,软腭受到的最大气流压力为-10.884 Pa,悬雍垂受到的最大气流压力为-51.946 Pa,气流对软腭和悬雍垂造成的最大剪切应力分别为78和311 mPa。在呼气阶段,上气道腔内最大流速为10.330 m/s,最大负压为-51.921 Pa,口咽部和鼻腔顶部均出现局部回流,且口咽部顺时针回流现象显著,软腭受到的最大气流压力为2.603 Pa,悬雍垂受到的最大气流压力为-18.222 Pa,软腭和悬雍垂受到的最大剪切应力分别为51和508 mPa。结论 口咽部是易塌陷的部位,一个呼吸循环过程的数值模拟可以捕捉到上气道流场显著的回流特征,上气道回流直接影响软腭和悬雍垂所受的力,同时也关系到患者呼吸的流畅程度。

    Abstract:

    Objective To study the flow characteristics of the upper airway and force dynamics of the soft palate and uvula in a representative male OSAHS (obstructive sleep apnea hypopnea syndrome) patient during normal respiration. Methods A CT image-based reliable geometry model of the upper airway was established. Numerical simulation boundary conditions were determined by clinical data of sleep monitoring, and the low-Reynolds number turbulence model was adopted to calculate the flow movement during a complete respiration period. Results The flow characteristics of the upper airway were obviously different in the breathing process of OSAHS patient. During inspiration, the maximum velocity of airflow in the upper airway reached 9.808 m/s, and the maximum negative pressure of airflow reached -78.856 Pa. Backflow districts were found at top of the nasal cavity. The maximum pressure on the soft palate was -10.884 Pa, and that on the uvula was -51.946 Pa. The maximum shear stress on the soft palate and uvula was 78 and 311 mPa, respectively. During expiration, the maximum velocity of airflow in the upper airway was 10.330 m/s, and the maximum negative pressure was -51.921 Pa. Backflow was observed to appear both at the oropharynx and top of the nasal cavity. Specifically, clockwise backflow was remarkable at the oropharynx. The maximum pressure on the soft palate was 2.603 Pa, and that on the uvula was -18.222 Pa. The maximum shear stress on the soft palate and uvula was 51 and 508 mPa, respectively. Conclusions Oropharynx is most likely to collapse in the upper airway. Numerical simulation on the respiratory cycle can capture the salient backflow features of the flow field in the upper airway. The backflow in the upper airway directly affects the forces on the soft palate and uvula and the breathing fluency of OSAHS patients.

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杨照,卢志明,孙涛,刘永义,高路,黄渊柏.典型男性OSAHS患者上气道气流运动特性的数值模拟[J].医用生物力学,2013,28(6):615-621

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  • 收稿日期:2012-09-26
  • 最后修改日期:2012-12-02
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  • 在线发布日期: 2013-12-06
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