Analysis of upper airway flow field between obstructive sleep apnea and normal children based on computational fluid dynamics
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摘要: 目的 运用计算流体力学(CFD)分析上气道气流流场特性, 分析正常儿童与阻塞性睡眠呼吸暂停(OSA)儿童上气道流场间的差异, 从气道流体力学方面阐述儿童OSA的病理特征。方法 构建正常儿童和OSA患儿上气道模型, 运用CFD方法模拟两者上气道吸气气流, 分析两者在同一吸气压强条件下气流流速、流动方式、通气量和气道压强等方面的差异, 并开展临床鼻阻力计测量和基于3D打印技术打印实体模型搭建体外实验验证CFD结果。结果 CFD结果与体外3D模型实验及临床测量结果相符合。OSA患儿鼻咽部腺样体区面积为11.274 mm2, 约为正常儿童的1/6。OSA患儿鼻咽部气流流速激增, 流线紊乱; 压强骤降, 占总压降的69.197%;鼻咽部阻力值是正常儿童的6.59倍。正常儿童通气量为116.139 mL/s, 而OSA患儿通气量为47.055 mL/s, 差异率高达59.48%。结论 OSA患儿鼻咽部气流流动较正常儿童有明显的差异。应用CFD可直观地显示气道流场的异常, 帮助临床医生进一步认识儿童OSA的发病机制。
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关键词:
- 儿童 /
- 睡眠呼吸暂停, 阻塞性 /
- 计算流体力学 /
- 鼻阻力计 /
- 腺样体肥大
Abstract: Objective In this study, the characteristics of the upper airway flow field were analyzed by using computational fluid dynamics(CFD). The study analyze the differences in the upper airway flow field between normal children and children with obstructive sleep apnea(OSA), and the pathological characteristics of children with OSA were elaborated from the perspective of airway fluid dynamics.Methods The upper airway models of a normal child and a child with OSA were constructed. The differences in the same inspiration pressure, such as airflow velocity, airflow pattern, ventilation volume, and pressure, were analyzed. To verify CFD results, rhinomanometry was carried out and an experimental bench based 3D technology was also built.Results The CFD results are consistent with the in vitro 3D model experiments and clinical measurement results. The adenoid area of nasopharynx is only 11.274 mm2of the child with OSA, about 1/6 of that of normal children. At the area of nasopharyngeal in OSA children, the flow velocity increased but the pressure dropped sharply, which was 69.197% of the total pressure drop, and the resistance value was 6.59 times of that of normal children. Streamline of nasopharyngeal is more disorder. Normal children's inspiratory flow was 116.139 mL/s, while OSA children's inspiratory flow was 47.055 mL/s, with a difference rate as high as 59.48%.Conclusion The airflow of OSA children in nasopharynx is significantly different from that of normal children. The airflow characteristics of upper airway were discussed in detail with the use of CFD, which can help clinicians intuitively understand the abnormal flow behavior of children with OSA.-
Key words:
- child /
- sleep apnea, obstructive /
- computational fluid dynamics /
- rhinomanometry /
- adenoid hypertrophy
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图 6 正常儿童(6a)和OSA患儿(6b)上气道壁面压强分布 箭头所指为最小压强处；图7 OSA患儿达到正常儿童通气量下的气道压强变化图 7a：通气量47.055 mL/s时的气道压强；7b：通气量116.139 mL/s时的气道压强
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