高原颅脑撞击伤的力学响应研究

With an increase of economical action and crowded varied population in high altitude in China, brain impact injuries have resulted in great harm to the health of people in the areas more and more.The intrinsic character of brain impact injury is mechanical response, namely brain deformation, stresses, in response to the external mechanical stimulation, exceeding the injury tolerance of tissue and cell, and the leading to injury to its structure and function. The characters of mechanical response of brain injury may change,with the change of the structure and function of brain of populations in high altitude owing to hypoxia compensation, causing prevention and treatment for the brain impact injury to need the corresponding strategy. The study, however, concerning brain injury in high altitude has lacked. The purpose of the project, therefore, is to investigate the characters of mechanical response of varied population in high altitude. Before conducting the experiments, the anoxic animals mimicing varied population in high altitude will be fed. The investigation to test brain tissue material property will be carried out using the animals. Then brain impact experiment will be performed, and stress of brain tissue in the experiment will be acquired via computer simulation with finite element model. The relationship between stress and injury will be studied, and then brain injury tolerace will be developed. To valide the threshold, the in-depth analysis for brain injuries in high altitude will be done. The mechanical synergistic effect of brain injury based on the animal experiment will be researched, so that the changes of pathophysiology will be studied detailedly. Combining the study above and epidemiological study for brain injuries, the spectrum of disease resulted from brain injuries in high altitude will be built. The execution on the project will promote the study for prevetion and treatment of brain impact injury in high altitude.

随着我国高原地区经济活动和各类人群增多，高原颅脑撞击伤的危害正日益严重。颅脑撞击伤的本质是力学响应，即颅脑对外力响应变形，超过组织、细胞耐受极限，引起其结构或功能损害。高原人群因颅脑结构和功能缺氧代偿，颅脑撞击伤的力学响应特性随之变化，使得高原颅脑撞击伤防护和救治需要相应策略，但我国尚缺相关研究。为研究高原不同人群颅脑撞击伤的力学响应特性，本课题拟饲养出多种缺氧程度的高原动物；进行高原动物脑组织材料力学实验，研究高原生物脑组织力学特性；开展高原颅脑撞击伤动物实验，用有限元模型计算颅脑损伤的组织应力，研究脑组织应力与颅脑损伤的量效关系，结合典型高原颅脑损伤深度分析，建立并验证高原颅脑撞击伤的损伤阈值；研究高原颅脑撞击伤的力学协同效应，进一步明确高原颅脑损伤的病生变化，结合高原颅脑损伤病例分析，建立高原颅脑损伤的疾病谱。实施本项目对促进高原颅脑撞击伤的防护和救治研究有重要作用。

通过脑组织材料力学实验、颅脑损伤流行病学调查及动物撞击实验，探索急进高原颅脑撞击伤的相关科学问题。研究结果及结论：进行生物软组织拉伸实验方法学研究，开展不同部位脑组织在多种应变率条件下的拉伸力学试验，建立力学本构方程，阐明脑组织拉伸力学特性。.研究我国高原道路交通事故特点，发现高原地区交通要素发生了显著变化，高原交通事故死亡率高，高原人群面临着严峻的交通安全隐患。通过高海拔地区创伤入院病例研究，明确了高原创伤谱（包括年龄、性别、民族、损伤类型、入院时间、损伤部位、损伤程度的分布特征），发现损伤部位、致伤因素和损伤严重程度与损伤转归/死亡相关，而性别、民族、入院季节、是否发生多发伤等与死亡率无直接相关关系。.研制了多功能生物撞击机，复制出分级闭合性颅脑撞击伤动物模型，能真实地模拟头部被撞击过程；研制了低压舱（能模拟不同海拔高度的高原低压缺氧环境），在平原地区制备了急进高原颅脑闭合性损伤的动物模型，为颅脑损伤研究及高原伤病研究提供了可靠的实验装置和动物模型。比较4000m海拔与平原颅脑撞击伤，发现高原颅脑撞击伤的损伤耐限明显降低；研究不同海拔颅脑损伤特性，发现低压缺氧与撞击对脑损伤存在协同效应；急进高原时颅脑损伤阈值降低，高原颅脑损伤防治装备与策略应不同于平原。.研究高原颅脑损伤海拔梯度效应，发现急进高原(6000m)后发生颅脑损伤滞留于原地时继发性损伤较严重；快速下降至低海拔(3000m)时脑肿胀明显；而阶梯性下降至低海拔(4500m)时尽管呼吸及酸碱代谢却较紊乱但脑肿胀控制较好。发现急进高原颅脑撞击伤的力学耐限低；阐明急进高原颅脑撞击伤的病生变化规律，提出高原颅脑交通伤的阶梯后送原则。本项目的实施为高原颅脑撞击伤的防治提供了数据支撑。.本课题已经按计划完成全部研究内容；发表5篇SCI论文，1篇EI论文，4篇中文论文；获得3项专利授权，在国际学术会议作报告2次；培养了1名博士和2名硕士。