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摘要:
为了探究伴侧支血管的髂静脉压迫综合征出现典型症状的原因，对一典型伴侧支血管的髂静脉血流场进行了数值研究。通过调节多孔介质模型的黏性阻力系数模拟髂静脉压迫综合征发展阶段中的第二阶段和第三阶段，分析和对比了两个阶段的压力梯度、血液螺旋度和壁面切应力等血流动力学特征。研究结果表明，第三阶段的左髂静脉和下腔静脉之间的压力梯度为107 Pa，远大于第二阶段的31 Pa，但小于髂静脉压迫综合征的判断标准266 Pa。在第三阶段，侧支血管代替了左髂静脉进行回流。随着血流路径的改变，侧支血管和右髂静脉的血液螺旋度和壁面切应力远大于第二阶段。左髂静脉的长期堵塞，改变了红细胞的输运路径，延长了输运时间。尽管伴侧支血管的髂静脉压迫综合征能够进行下肢回流，患者仍呈现典型症状的原因可能是较大的压力梯度、较大的血液螺旋度、异常壁面切应力以及红细胞的输运迟滞长期的共同作用。
Abstract:To investigate the reasons for the typical symptoms of iliac vein compression syndrome with the collateral veins, a typical iliac vein blood flow field with a collateral vein was numerically studied. The viscous resistance coefficient of the porous media model was adjusted to simulate the second and third development stages of iliac vein compression syndrome. The hemodynamic characteristics in the two stages were analyzed and compared, e.g., pressure gradient, blood helicity, and wall shear stress. The results show that the pressure gradient between the left iliac vein and the inferior vena cava is 107 Pa in the third stage, which is far greater than 31 Pa in the second stage but less than the criterion of iliac vein compression syndrome, i.e., 266 Pa. In the third stage, the left iliac vein is replaced by the collateral vein to realize the venous blood flow. When the blood flow pathway changes, the blood helicity and wall shear stress in the collateral vein and right iliac vein are much greater than those in the second stage. The obstruction of the left iliac vein changes the transport pathway of the erythrocyte and prolongs the transport time. Although the venous blood flow in iliac vein compression syndrome with the collateral vein is normal, the patient still presents the typical symptoms due to the combined effort of the excessive pressure gradient, large blood helicity, abnormal wall shear stress, and transport hysteresis of erythrocytes.
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Key words:
- iliac vein compression syndrome /
- hemodynamics /
- numerical simulation /
- porous media /
- blood helicity
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图 2 参数a随黏性阻力系数θ的变化曲线
Figure 2. Variation curve of parameter a with viscous resistance coefficient θ
图 3 不同网格方案下“截面4”的速度分布
Figure 3. Velocity distribution of “Section 4” with different mesh schemes
表 1 4组网格方案
Table 1. Four groups of mesh schemes
类型 网格数n 类型 网格数n Ⅰ 4 040 840 Ⅲ 8 484 195 Ⅱ 6 314 302 Ⅳ 10 904 253 
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