血液灌注式亚低温治疗人脑降温过程的数值研究

      Numerical Study on the Process of Human Brain Cooling Treated by Hemoperfusion Mild Hypothermia

      • 摘要: 亚低温治疗作为一种常用的术中保护患者神经组织的手段,目前在临床上已经得到了一定的应用。对比传统的冷冻头盔和鼻咽冷却等手段,低温血液灌注被认为是一种很有前景的亚低温治疗方案,但该方案缺乏实验和理论验证其降温效果。该研究通过商用有限元仿真软件COMSOL将Pennes方程与简化的脑血管网络模型相结合,构建了全新的简化人脑模型;并进一步利用该模型模拟了脑部低温血液灌注的降温过程。仿真结果表明,当灌注的低温血液为33 ℃时,人脑可以在4 min左右进入亚低温状态。通过与头盔式降温相比,验证了血液灌注方案的可行性和高效性;通过与基于Pennes方程的计算结果相比,验证了所构建模型的合理性。该模型具有无创预测患者术中脑部温度变化的潜力,为血液温度等治疗参数的设定提供参考,从而有助于个性化实现更加安全有效的亚低温神经组织保护。

         

        Abstract: Mild hypothermia, as a common means of intraoperative nerve protection, has been used in clinical practice. Compared with the traditional methods such as freezing helmet and nasopharyngeal cooling, hypothermic blood perfusion is considered to be a promising treatment for mild hypothermia, but it lacks experimental and theoretical verification of its cooling effect. In this study, the commercial finite element simulation software COMSOL combined the Pennes equation with the cerebrovascular network model to construct a new simplified human brain model, which was further used to simulate the cooling process of cerebral hypothermic blood perfusion. When the hypothermic blood perfusion was 33 ℃, the human brain could enter the mild hypothermic state within 4 minutes. By comparing with helmet cooling, the feasibility and efficiency of the blood perfusion scheme were verified. By comparing with the calculation results based on Pennes equation, the rationality of the model constructed in this study were verified. This model can non-intrusively predict the changes of brain temperature during surgery, and provide a reference for the setting of treatment parameters such as blood temperature, so as to provide personalized realization of safer and more effective mild hypothermia neuro protection.

         

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