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颅脑爆炸伤致伤机制及防护研究进展

柳占立 杜智博 张家瑞 严子铭 栗志杰 王鹏 康越 黄献聪 马天 费舟 庄茁

柳占立, 杜智博, 张家瑞, 严子铭, 栗志杰, 王鹏, 康越, 黄献聪, 马天, 费舟, 庄茁. 颅脑爆炸伤致伤机制及防护研究进展[J]. 爆炸与冲击, 2022, 42(4): 041101. doi: 10.11883/bzycj-2021-0053
引用本文: 柳占立, 杜智博, 张家瑞, 严子铭, 栗志杰, 王鹏, 康越, 黄献聪, 马天, 费舟, 庄茁. 颅脑爆炸伤致伤机制及防护研究进展[J]. 爆炸与冲击, 2022, 42(4): 041101. doi: 10.11883/bzycj-2021-0053
LIU Zhanli, DU Zhibo, ZHANG Jiarui, YAN Ziming, LI Zhijie, WANG Peng, KANG Yue, HUANG Xiancong, MA Tian, FEI Zhou, ZHUANG Zhuo. Progress in the mechanism and protection of blast-induced traumatic brain injury[J]. Explosion And Shock Waves, 2022, 42(4): 041101. doi: 10.11883/bzycj-2021-0053
Citation: LIU Zhanli, DU Zhibo, ZHANG Jiarui, YAN Ziming, LI Zhijie, WANG Peng, KANG Yue, HUANG Xiancong, MA Tian, FEI Zhou, ZHUANG Zhuo. Progress in the mechanism and protection of blast-induced traumatic brain injury[J]. Explosion And Shock Waves, 2022, 42(4): 041101. doi: 10.11883/bzycj-2021-0053

颅脑爆炸伤致伤机制及防护研究进展

doi: 10.11883/bzycj-2021-0053
详细信息
    作者简介:

    柳占立(1981- ),男,博士,副教授,liuzhanli@mail.tsinghua.edu.cn

    通讯作者:

    庄 茁(1952- ),男,博士,教授,博士生导师,zhuangz@tsinghua.edu.cn

  • 中图分类号: O389

Progress in the mechanism and protection of blast-induced traumatic brain injury

  • 摘要: 颅脑爆炸伤是现代战争中士兵面临的主要伤害之一,近年来受到广泛关注。冲击波经由颅脑传播带来的直接伤害被称为初级爆炸伤。目前,初级颅脑爆炸伤致伤机制尚不明确,可能是应力波传播、颅骨弯曲变形、颅脑空化及躯干压缩等多种因素共同作用的结果。该研究是涉及多学科交叉、多物理场耦合及短时和长时效应共存的复杂问题,需要通过建立描述冲击波和颅脑相互作用的高精度、多尺度和多物理场数值模型,发展测量颅骨应变、颅内压力、加速度等力学指标的物理测试系统,结合人体和动物病理、生理、行为学等综合因素分析,最终揭示颅脑爆炸伤致伤机制。本文中介绍了初级颅脑爆炸伤致伤机制,给出了颅脑爆炸伤的行为学、生理学相关的医学评价指标,以及颅骨应变、颅内压力等关键力学评估指标,提出了基于致伤机制和评价指标的防护结构设计方法,包括基于新型防冲击波材料的头盔系统改进、头盔缓冲系统设计、增加头部保护系统的封闭性等,最后展望了在精细化建模、原位实验及防护系统设计等诸多方面的发展趋势。
  • 1(a)  爆炸冲击波引起颅脑损伤[9]

    1(a).  Traumatic brain injury caused by blast wave[9]

    图  1(b)  爆炸冲击波载荷特点

    Figure  1(b).  Characteristics of blast loading

    图  2  颅骨弯曲变形过程[31]

    Figure  2.  Flexural deformation process of the skull[31]

    图  3  颅骨振动有限元模拟[35]

    Figure  3.  Finite element simulation of the flexural deformation of the skull[35]

    图  4  冲击波正面作用时颅脑压力云图与颅骨变形云图[37]

    Figure  4.  Nephograms of the brain pressure and skull displacement caused by the frontal impact of the blast wave[37]

    图  5  大脑椭球体模型的二维示意图[43]

    Figure  5.  Two dimensional diagrams of the brain ellipsoid model[43]

    图  6  直径457 mm的激波管示意图[44]

    Figure  6.  The shock tube of 457 mm in diameter[44]

    图  7  研究bTBI的多尺度数值模型[51]

    Figure  7.  Multi-scale numerical model for bTBI study[51]

    图  8  损伤分类

    Figure  8.  Damage classification

    图  9  人体头部及肺部冲击波超压耐受曲线[60]

    Figure  9.  Shock wave overpressure tolerance curves of the human head and lungs[60]

    图  10  高仿真头颈部模型主要传感器的布置(清华大学)[62]

    Figure  10.  Sensor layout on the high-fidelity head and neck model (Tsinghua University)[62]

    图  11  高仿真头颈部模型与激波管实验平台[62]

    Figure  11.  High-fidelity head and neck model and shock tube experimental platform[62]

    图  12  实爆实验布置情况[63]

    Figure  12.  Layout of the explosion experiment[63]

    图  13  头部压力监测位置[63]

    Figure  13.  Head pressure monitoring positions[63]

    图  14  爆炸性颅脑损伤(bTBI)模型的细节[65]

    Figure  14.  Details of the model of explosive brain injury (bTBI)[65]

    图  15  爆破实验装置[66]

    Figure  15.  Blasting experimental device[66]

    图  16  大鼠头部暴露的位置[67]

    Figure  16.  Location of rat head exposed [67]

    图  17  不同头盔的防护效能[78]

    Figure  17.  Protection effectiveness of different helmets[78]

    图  18  头部矢状面和冠状面以及头盔构形[80]

    Figure  18.  The vertical plane and coronal plane of the head, as well as the helmet configuration[80]

    图  19  泡沫材料对矢状面和冠状面模型的影响[80]

    Figure  19.  Influences of the foam material on the sagittal model and coronal plane model[80]

    图  20  不同厚度泡沫垫的应力时程曲线[81]

    Figure  20.  The time history of stress in the foam pads of different thicknesses[81]

    图  21  不同性能泡沫垫中应力的时间历程[81]

    Figure  21.  The time histories of stress in the foam pads with different properties[81]

    图  22  排爆头盔模型[82]

    Figure  22.  Explosive ordnance disposal helmet model[82]

    图  23  全系统头部防护(头盔+眼部防护装置+下颚部防护装置)[53]

    Figure  23.  Full system head protection (helmet + visor + mandibular shield)[53]

    图  24  不同头部防护组合的效果对比[53]

    Figure  24.  Comparison of the effects of different head protection combinations[53]

    图  25  装备多层防护面罩头盔的仿真模型[83]

    Figure  25.  Simulation model of helmet equipped with a multi-layer face shield[83]

    图  26  面部结构防护效果对比[83]

    Figure  26.  Comparison of the facial protective effects[83]

    表  1  格拉斯哥昏迷评分

    Table  1.   Glasgow coma scale (GCS)

    评分眼睛状况口头表达动态行为
    无法监测例如:严重的眼外伤例如:插管例如:瘫痪
    1不睁眼不能言语刺痛下肢体不动
    2刺痛睁眼只能发音刺痛下有肢体伸直
    3呼唤睁眼回答含糊不清刺痛下有肢体屈曲
    4自动睁眼回答有错误刺痛下有躲避反应
    5回答正确能定位刺痛位置
    6按吩咐动作
    下载: 导出CSV

    表  2  致伤阈值相关性[54]

    Table  2.   Correlation of the injury threshold[54]

    致伤阈值计算受伤区域与行为学损伤区域匹配相关度
    标准压力/PaMises应力/Pa等效应变体积能量率/(J·s−1剪切能量率/(J·s−1轴突拉伸轴突拉伸能量率/(J·s−1
    灰质5639565672
    白质44334422443356
    下载: 导出CSV

    表  3  bTBI常见医学指标[71]

    Table  3.   Common medical indexes of bTBI[71]

    事件机制血清生物标志物
    轻度创伤性脑损伤中度创伤性脑损伤严重创伤性脑损伤
    神经元和神经胶质细胞死亡激活触发坏死和/
    或凋亡的因子
    神经元:NSE,Ctau,SBP,
    所有血影蛋白
    神经元:NSE, PNF-H, NF-H,
    NMDAR, Hsp70, UCH-L1, C-tau,
    所有血影蛋白, SBP,促泌素
    神经元:NSE, PNF-H, NF-H,NMDAR, Hsp70, UCH-L1, C-tau,
    所有血影蛋白, SBP, 促泌素
    神经胶质:S100β,
    GFAP,MBP,C-tau
    神经胶质: S100β, GFAP,MBP,
    NMDAR, Hsp70, IL-1β, L-6, L-8,
    TN-α,C-tau, AQP4
    神经胶质: S100β, GFAP, MBP, NMDAR, Hsp70, IL-1β, IL-6,
    IL-8, TN-α, C-tau, AQP4
    血管
    痉挛
    血管收缩和松弛的失调Hsp70, TNF-α, VEGF,
    Claudin-5, vWF
    Hsp70, TNF-α, VEGF,
    Claudin-5, vWF
    水肿毒性和炎症因子引起的血管生成和细胞毒性事件Hsp70, IL-1β, IL-6, IL-8, VEGF, Claudin-5, vWF, AQP4, MMP9Hsp70, IL-1β, IL-6, IL-8, VEGF, Claudin-5, vWF, AQP4, MMP9
    轴突
    损伤
    机械损伤;神经元变性S100β, NSE, C-tau, MBP,
    SBP, 所有血影蛋白
    S100β, MBP, NSE, PNF-H, NMDAR, Hsp70, C-tau,
    所有血影蛋白, SBP
    S100β, MBP, NSE, PNF-H, NMDAR, Hsp70, C-tau,
    所有血影蛋白, SBP
    炎症细胞因子释放与细胞应激IL-1β, IL-6, IL-8,
    TNF-α, IFN -γ
    Hsp70, IL-1β, IL-6,
    IL-8, TNF-α, IFN -γ
    Hsp70, IL-1β, IL-6, IL-8,
    TNF-α, IFN -γ
    代谢
    变化
    缺氧;能量需求改变、
    离子稳态与神经传递;
    增加了修复过程
    血浆铜蓝蛋白,HIF-1α血浆铜蓝蛋白,HIF-1α
    下载: 导出CSV
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  • 收稿日期:  2021-02-03
  • 修回日期:  2021-12-20
  • 网络出版日期:  2022-03-29
  • 刊出日期:  2022-05-09

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