基于力学响应耦合的颅脑损伤累积效应定量研究

Traumatic brain injury is the leading cause of casualties in road traffic accidents. When the head suffers from two successive impacts, it will lead to the secondary accumulation of brain injury.It is common in pedestrian collisions where the pedestrian's head collides with the vehicle and the ground. In fact, since the cumulative effect and quantitative relationship between two successive impact injuries is not yet clear, it is not rigorous that the results of two successive impact damages of the cranium are regarded as the direct vehicle impact damage in the traffic injury researches. Therefore, it is of great significance to carry out researches for the clinical treatment of craniocerebral injury, the protection against traffic injury and the restoration of the truth of the accident. This research is based on animal experiments. Firstly, a light, medium, and severe grading injury experiment will be performed on rabbit craniocerebral tempus. Secondly, the traumatic experiment of rabbit craniocerebral tempus will be carried out by two consecutive impacts. And based on its damage results, the equivalent experiment of single craniocerebral temporal impact could be obtained. Finally, the experimental data will be summarized and analyzed, and the cumulative effect and quantitative relationship of brain injury caused by two consecutive impacts were determined, which will be verified by two cases of typical pedestrian-vehicle collisions.

颅脑损伤是道路交通事故中人员伤亡的最主要原因，当头部遭受两次连续撞击则会导致颅脑损伤的二次累积，常见于人车碰撞中行人头部先后与车辆和地面发生撞击。事实上，由于颅脑两次连续撞击损伤的累积效应及其定量关系还不十分明确，在交通伤研究中将颅脑两次连续撞击损伤近似等效车辆直接撞击的伤害结果是不严谨的。因此，开展相关研究对颅脑损伤的临床救治、交通伤防护及事故真相的还原都具有重要意义。本项目以动物实验为基础，首先开展兔颅脑颞部单次撞击致轻中重度损伤分级实验；其次，开展兔颅脑颞部两次连续撞击致伤实验，并以两次连续撞击后的损伤结果为依据，寻找与之损伤结果相同的兔颅脑颞部单次撞击等效实验；最后，总结分析实验数据，明确两次连续撞击致颅脑损伤的累积效应及其定量关系，并通过两例典型人车碰撞事故案例进行验证。

颅脑损伤是道路交通事故的主要损伤类型和死亡原因，在真实的头部碰撞事件中头部遭受重复碰撞的情形较为常见，重复颅脑损伤常见于人-车碰撞、接触性运动事件、爆炸冲击及暴力袭击等创伤事件中，因此，明确颅脑损伤累积效应对其防护及救治具有重要意义。本项目按照研究计划分别完成了：①明确了颅脑损伤的事故特点和伤情分布特点，分析了颅骨骨折及颅脑损伤的交叉关联关系，提出传统基于颅骨骨折而构建的HIC评价准则未纳入真实损伤累积效应的局限性。同时，提出事故现场颅脑损伤的伤害控制时效性，为颅脑损伤防治提供了方向。②重建了50例典型人-车和人-地碰撞过程，分别获取车辆碰撞和地面碰撞导致的颅脑损伤力学响应参数，进而对比行人实际损伤后果以判断了真实颅脑损伤的累积效应规律。同时，对其中33例人-车碰撞的颅脑损伤重建，提出综合考虑时间和累积应变的颅脑损伤准则HCSDM。③建立了单次撞击致颅脑损伤的分级动物模型，并以此为基础建立急性重复颅脑损伤的动物模型。明确了颅脑损伤的累积效应规律，轻度颅脑损伤叠加并未导致最终损伤成倍增加，进一步得到颅脑损伤累积效应的非线性关系。重复颅脑损伤的力学响应与颅骨骨折具有明显的相关性，传统颅脑损伤HIC准则需要进一步纳入颅脑损伤的累积效应。同时，发现不同颅脑损伤程度的叠加顺序并不会导致明显的损伤后果改变。本项目实施对颅脑损伤的生物力学评价准则研究具有重要意义。