tips ls及其并发症对肝门静脉系统血流动力学影响的分析与cfd模拟-analysis and cfd simulation of tips ls and its complications on hemodynamics of hepatic portal vein system.docx

ABSTRACTPortal hypertension is an increase in the blood pressure within the portal venous system, and the most common cause of portal hypertension is /dict_result.aspx?searchword=%e8%82%9d%e8%84%8f%e7%96%be%e7%97%85amp;tjType=sentenceamp;styleamp;t=liver%2Bdiseasesliver disease. The main symptoms of portal hypertension include /content/article/90/100610.htmgastrointestinal bleeding and ascites. Transjugular Intrahepatical Portosystemic Shunt (TIPS) and Laparoscopic Splenectomy (LS) are both important treatments for portal hypertension, since they have /dict_result.aspx?searchword=%e6%88%90%e5%8a%9f%e7%8e%87%e9%ab%98amp;tjType=sentenceamp;styleamp;t=high%2Bsuccess%2Bratehigh success rate, less trauma and rapid postoperative recovery. TIPS and LS have different effects on hemodynamics after operation and some surgical complications are closely related to changes of blood flow. Study the changes of hemodynamic parameters have important significance on treatments and prevention of surgical complications. Portal venous system thrombosis (PVST) can be a serious and potentially fatal complication of TIPS and LS. PVST is also closely related to changes in hemodynamic parameters. In this paper, we mainly research on the following aspects:Firstly, based on established numerical methods, CFD technique is applied to analyze hemodynamic changes after TIPS and LS. According to the CT images and ultrasound taken after the surgery, two sequential models of portal venous system (post-TIPS and post-LS) were constructed. Using the 3-D models we were able to simulate the blood flow within patient-specific TIPS system and portal venous system post-LS. Simulation results show that the streamlines became much complex after operation TIPS and a high wall shear stress region occurs before the TIPS stent. Low blood flow velocity make the wall shear stress is very low and distributed more evenly after LS. The presented computational model can be used for the theoretical analysis o