%0 Journal Article %T 基于有限元模型的经阴道分娩产妇子宫瘢痕处最大应力分析<br>Analysis on the maximum stress of uterine scar during delivery based on finite element model %A 王贤达 %A 贺 %A 磊 %A 马新刚 %A 董瑞春 %A 孟颜颜 %J 郑州大学学报（医学版） %D 2018 %R 10.13705/j.issn.1671-6825.2018.03.133 %X 目的:基于有限元模型分析分娩时产妇子宫瘢痕处的应力情况,用以判断分娩方式。方法:通过查阅文献资料建立子宫的三维简化模型,在有限元软件ANSYS workbench中设置子宫前壁上、下段和子宫瘢痕厚度以及宫内压力,计算子宫瘢痕处的应力,判断经阴道分娩子宫破裂的风险。结果与结论:通过ANSYS workbench得到了分娩时子宫应力分布图,最大应力位于子宫瘢痕处。固定子宫前壁上段厚度为10.0 mm,当子宫前壁下段和子宫瘢痕厚度从1.0 mm逐渐增至6.0 mm时,子宫瘢痕处受到的最大应力逐渐减小。当子宫瘢痕厚度小于3.0 mm时,经阴道分娩时子宫瘢痕处的最大应力大于此处的抗拉强度,此时不建议顺产。固定子宫瘢痕厚度为3.0 mm,当子宫前壁上段厚度在4.5～10.0 mm时选择顺产比较安全; 子宫瘢痕处应力随着子宫前壁上段厚度的增加先减小后增大,当子宫前壁上段厚度达7.0 mm时瘢痕处的应力达到最小值。<br>Aim:To assess the way of delivery according to the maximum stress of uterine scar based on finite element model.Methods:Through consulting the literature, a three-dimensional simplified model of the uterus was established. The thicknesses of the upper uterine segment, lower uterine segment and the uterine scar, as well as the intrauterine pressure were set, and the force at the scar was obtained and the risk of uterine rupture during vaginal trial production was assessed.Results and Conclusion:The stress distribution of the uterus was calculated by ANSYS workbench, and the maximum stress was located at the uterine scar. When the thickness of the upper uterine segment was set as 10.0 mm,the stress at the uterine scar decreased with the increase of the thicknesses(1.0-6.0 mm)of the lower uterine segment and the uterine scar; when the thickness of the uterine scar was less than 3.0 mm, the maximum stress at the uterine scar was greater than the strength of the uterine scar muscle, and vaginal delivery was no recommended. When the thickness of the uterine scar was set as 3.0 mm, the thickness of the upper uterine segment was at the range of 4.5-10.0 mm, vaginal delivery is relatively safe. The stress at the uterine scar decreases first and then increases with the increase in the thickness of the upper uterine scar. The stress at the uterine scar is the lowest when the thickness of the upper uterine segment is 7.0 mm %K 瘢痕子宫 %K 阴道试产 %K 重复剖宫产 %K 子宫破裂 %K 抗拉强度< %K br> %K scar uterus %K vaginal trial production %K repeat cesarean section %K uterine rupture %K tensile strength %U http://jms.zzu.edu.cn/oa/darticle.aspx?type=view&id=201806026