经阴道分娩瘢痕子宫破裂预警的有限元分析
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1.淄博市妇幼保健院;2.淄博市妇幼保健院产科;3.山东理工大学机械工程学院

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淄博市科技发展计划项目(2016kj010029)通信作者于迎春,主任医师,主要从事危重症产妇的研究。E-mail:2436999837@ qq.com


Finite Element Analysis of Scar Uterine Rupture Warning In Vaginal Delivery
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    摘要:

    目的 以往主要是通过超声监测判断瘢痕子宫能否经阴分娩,本文应用有限元法分析瘢痕子宫受力与瘢痕厚度及位置的关系,研究瘢痕子宫破裂预警,进而选择分娩方式。方法 首先应用SOLIDWORKS建立足月子宫的三维模型,然后在ANSYS软件中设置宫内压力、瘢痕厚度及位置,计算子宫受力。结果 在宫缩过程中,最大应力位于子宫瘢痕处;以3mm作为子宫下体厚度界限,若测量厚度小于3mm,子宫破裂应立即选择剖宫产,反之可以选择经阴分娩;当瘢痕厚度为3.0mm时,子宫所受最大应力随着与子宫底距离的增加先减小后增大,在距离子宫底295mm时子宫瘢痕处的应力最小;瘢痕距离子宫底为285-305mm时,瘢痕所受极限应力小于其抗拉强度,选择顺产是比较安全的。结论 本文基于ANSYS有限元分析以一种新方法研究了瘢痕子宫破裂预警,分析结果与临床资料相符,为分娩方式的选择提供了分析方法和理论指导。

    Abstract:

    Objective In the past, ultrasound was mainly used to determine whether the scar uterus can be delivered through vagina. In this paper, this paper uses the finite element method to analyze the relationship between scar uterine stress and scar thickness and position., and then choose the delivery method. Methods First, SOLIDWORKS was used to establish a three-dimensional model of the full-term uterus, and then the intrauterine pressure, scar thickness and position were set in ANSYS software to calculate the uterine force. Results During the contraction process, the maximum stress is located in the uterine scar; 3mm is used as the thickness limit of the lower uterine body. If the thickness is less than 3mm, cesarean section should be selected immediately. Otherwise, transvaginal delivery can be selected. When the scar thickness is 3.0mm The maximum stress experienced by the uterus decreases first and then increases as the distance from the uterine floor increases. The stress at the uterine scar is the smallest when the distance from the uterine floor is 295mm; when the scar is 285-305mm from the uterine floor, the ultimate stress on the scar is less With regard to its tensile strength, it is safer to choose a natural product. Conclusion Based on ANSYS finite element analysis, a new method is used to study the early warning of scar uterine rupture. The analysis results are consistent with clinical data, and provide analysis methods and theoretical guidance for the choice of delivery methods.

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  • 收稿日期:2020-03-31
  • 最后修改日期:2020-05-07
  • 录用日期:2020-05-12
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