流-固耦合作用下小尺寸肾结石引发的输尿管疼痛响应

刘勇岗; 苏丽君

doi:10.21656/1000-0887.450095

流-固耦合作用下小尺寸肾结石引发的输尿管疼痛响应

doi: 10.21656/1000-0887.450095

刘勇岗^{1, 2, ,},
苏丽君^{3, 4}

1.
延安大学感觉与运动疾病转化医学研究中心，陕西延安 716000
2.
延安市运动康复医学重点实验室，陕西延安 716000
3.
南京航空航天大学航空航天结构力学及控制全国重点实验室，南京 210016
4.
南京航空航天大学多功能轻量化材料与结构工信部重点实验室，南京 210016

基金项目:

国家自然科学基金(重点项目) 12032010

详细信息

通讯作者:
刘勇岗(1991—)，男，讲师，博士(通讯作者. E-mail: lyg@yau.edu.cn)

中图分类号: O347
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- 文章访问数: 113
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-11
- 修回日期: 2024-05-28
- 刊出日期: 2024-06-01

Responses of Ureteral Pain Caused by Small-Sized Kidney Stones Under Fluid-Structure Coupling

LIU Yonggang^{1, 2
, ,},
SU Lijun^{3, 4}

1.
Center for Translational Medicine Research on Sensory-Motor Diseases, Yan'an University, Yan'an, Shaanxi 716000, P.R.China
2.
Yan'an Key Laboratory of Sports Rehabilitation Medicine, Yan'an, Shaanxi 716000, P.R.China
3.
State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, P.R.China
4.
MIIT Key Laboratory of Multifunctional Lightweight Materials and Structures, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, P.R.China

摘要

摘要:
肾结石引发的输尿管疼痛长期折磨着人类，严重影响着人们的生活质量. 然而，目前临床上由于缺乏肾结石与输尿管相互作用的定量分析，泌尿医师无法针对不同患者制定精准的个性化治疗及镇痛方案. 针对该问题，以小尺寸肾结石为例，基于耦合Euler-Lagrange(CEL)算法的流-固耦合有限元方法分析了进入输尿管管腔内的小尺寸肾结石与输尿管的相互作用规律，并基于已建立的输尿管疼痛模型，对由输尿管内小尺寸肾结石引发的输尿管疼痛进行了定量化研究. 有限元分析结果表明，当结石直径小于输尿管内径时，结石会在输尿管壁蠕动作用下与输尿管发生动态接触，造成输尿管内壁上出现动态应力. 随着输尿管壁蠕动幅度增大，结石的移动速度增大，且结石与输尿管接触的概率减小，同时输尿管壁上的接触应力也会降低. 将应力结果输入输尿管疼痛模型计算对应的中心传输神经元细胞膜电位，结果表明，疼痛水平随时间的变化与动态应力随时间的变化趋势类似，在应力交替变化的情况下，疼痛程度并不会随应力降为零应力而降低至疼痛阈值以下，表现出疼痛程度与应力水平不对等的特征. 该研究所得结果可以结合当前临床上已有的医学影像技术和计算机领域的大数据与人工智能等技术，有望为个性化精准诊断结石患者病况并定量化评估患者疼痛程度，从而制定个性化治疗方案的精准医疗临床策略提供理论基础.
- 流-固耦合 /
- 耦合Euler-Lagrange(CEL)算法 /
- 输尿管软组织 /
- 神经电生理 /
- 疼痛量化
Abstract:
The ureteral pain caused by kidney stones has long tormented humans and seriously affected their quality of life. However, currently, in clinical practice, due to the lack of quantitative analysis of the interaction between kidney stones and ureters, urologists are unable to develop precise personalized treatment and pain relief plans for different patients. In response to this issue, small-sized kidney stones were taken as an example and to analyze the interaction behavior between small-sized kidney stones entering the ureteral lumen and the ureter with a fluid-structure coupling finite element method based on the coupled Eulerian-Lagrangian (CEL) algorithm. With the established ureteral pain model, the ureteral pain caused by small-sized kidney stones was quantitatively studied. The finite element analysis results indicate that, when the stone diameter is smaller than the inner diameter of the ureter, the stone will dynamically contact the ureter under peristalsis of the ureter wall, causing dynamic stress on the inner wall of the ureter. The stone moving speed will increase with the peristaltic amplitude of the ureteral wall, but the contacting probability between the stone and the ureter will decrease, and the contacting stress on the ureteral wall will decrease as well. The stress results were input into the ureteral pain model to calculate the corresponding central transmission neuron cell membrane potential. The model results show that, the change in the pain level over time was similar to the trend of dynamic stresses over time. In the case of alternating stress changes, the pain level would not decrease below the pain threshold as the stress drops to 0, showing inconformity between the pain level and the stress level. The results can be combined with existing medical imaging technologies in clinical practices, as well as big data and artificial intelligence technologies in the field of computer science. The research provides a theoretical basis for personalized and accurate diagnosis of the condition of stone patients, quantitative evaluation of patient pain levels, and the development of personalized treatment plans for precise medical clinical strategies.
- fluid-structure coupling /
- coupled Eulerian-Lagrangian (CEL) algorithm /
- ureteral soft tissue /
- neuroelectrophysiology /
- quantification of pain sensation

HTML全文

图 1 人体泌尿系统

Figure 1. The human urinary system

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图 2 输尿管解剖结构(横截面)^[7]

注为了解释图中的颜色，读者可以参考本文的电子网页版本，后同.

Figure 2. The anatomical structure of the ureter (cross-section)^[7]

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图 3 输尿管壁的解剖结构及机械力刺激引起的痛觉信号传递

Figure 3. The anatomical structure of the ureteral wall and the pain signal transmission caused by mechanical stimulation

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图 4 疼痛统一模型示意图

Figure 4. Schematic diagram of the holistic pain model

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图 5 基于疼痛统一模型的输尿管疼痛量化模型

Figure 5. The quantitative model for the ureteral pain based on the holistic pain model

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图 6 输尿管中不同尺寸肾结石示意图

Figure 6. Schematic diagram of kidney stones with different sizes in the ureter lumen

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图 7 结石与输尿管三维CEL有限元建模

Figure 7. The 3D CEL finite element modeling of stones and ureters

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图 8 结石与输尿管三维CEL有限元模型

Figure 8. The 3D CEL finite element model for stones and ureters

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图 9 蠕动状态下输尿管管壁上间距为Δz的两质点的运动状态示意

Figure 9. The schematic of the motion state of 2 mass points with distance Δz in the ureter wall under the peristaltic state

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图 10 三维CEL模型输尿管壁结点位移载荷施加

Figure 10. Application of node displacement loads for the 3D CEL model of ureteral wall

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图 11 输尿管管壁蠕动振幅比φ=0.2时结石运动的位移-时间曲线

Figure 11. The displacement-time curve of kidney stone movement under φ=0.2

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图 12 输尿管管壁蠕动振幅比φ=0.2时，结石与管壁接触引起的管壁应力状态变化

Figure 12. The changes in stresss states of the ureter wall caused by the contact between the stone and the ureter wall under dimensionless peristaltic amplitude of ureteral wall φ=0.2

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图 13 输尿管管壁蠕动振幅比φ=0.4时，对应的结石的位移-时间曲线与管壁接触面上最大主应力云图

Figure 13. The curve of the kidney stone displacement vs. the time and the maximum principal stress distribution on the contact surface of the ureter wall under the dimensionless peristaltic amplitude of ureteral wall φ=0.4

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图 14 输尿管管壁蠕动振幅比φ=0.6时对应的结石在管腔中的相对位置与结石运动的位移-时间曲线

Figure 14. The kidney stone location in the ureter lumen and the curve of the kidney stone displacement vs. the time under the dimensionless peristaltic amplitude of ureteral wall φ=0.6

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图 15 小尺寸结石引发输尿管疼痛响应的量化计算

Figure 15. Quantitative calculations of ureteral pain responses caused by small-sized stones

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表 1 尿液介质本构材料参数

Table 1. Constitutive parameters of the urinary liquid

quantity	value
dynamic viscosity μ/(MPa·s)	10^-5
initial density ρ_f0/(t/mm³)	10^-9
sound speed in urinary liquid c_f0/(mm/s)	1.5×10⁶^[31]
material constant Γ₀	0^[32]
material constant s	0^[32]

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表 2 人类输尿管的4参数Fung超弹性模型本构参数^[34]

Table 2. Constitutive parameters of the 4-parameter Fung hyperelastic model for human ureter^[34]

parameter	C/MPa	A_θθθθ	A_zzzz	A_θθzz
value	0.405 6	0.709 1	0.185 6	0.889 2

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表 3 三维CEL模型输尿管黏弹性部分的Prony级数参数

Table 3. Prony parameters of the viscoelastic part of the ureter in the 3D CEL model

number of terms i	g_i	k_i	τ_i/s
1	0.28	0	5.63
2	0.20	0	69.65

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表 4 三维CEL模型的基准参数

Table 4. Datum parameters of the 3D CEL model

parameter	value
inner radius of ureter R_in/mm	20
outer radius of ureter R_out/mm	36
amplitude of peristaltic wave A_w/mm	4
wavelength of peristaltic wave λ/mm	200
wave speed of peristaltic wave c/(mm/s)	200
kinematic viscosity of urinary liquid ν/(mm²/s)	400
density of urinary liquid ρ_l/(t/mm³)	10^-9
radius of kidney stone R_s/mm	20
density of kidney stone ρ_s/(t/mm³)	2×10^-9

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表 5 三维CEL模型的基准无量纲参数

Table 5. Datum dimensionless parameters for the 3D CEL models

parameter	value
dimensionless size of kidney stone ξ	1.0
Reynolds number Re	1.0
dimensionless thickness of ureter wall η	1.8
dimensionless peristaltic amplitude of ureter wall φ	0.2
peristaltic wave number of ureter wall β	0.1
dimensionless density of kidney stone ψ	2.0

下载: 导出CSV

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