本文利用數值計算方法，模擬睡眠呼吸中止症患者之肌肉組織特性，並於特定範圍之身體質量指數(Body Mass Index， BMI)下，歸納出一組肌肉材料係數，藉此估計患者手術後之呼吸道擴張情形，以提供醫生手術前之評估參考。
首先，蒐集3位BMI相近(20.5、22.9、23.1)患者於手術前後之電腦斷層掃描(Computed Tomography，CT)影像，分別重建出手術前後的下頷骨、呼吸道，下頷及頸部之肌肉組織與外型。再利用固體力學計算模擬手術後情形，稱之為虛擬手術方法，並將肌肉材料性質假設為彈性(elasticity)、非等向性(anisotropy)及均質材料(homogeneous materials)；將病患於臨床手術前、臨床手術後與虛擬手術後3種時期之上呼吸道以計算流體力學進行吸氣模擬，採用k-ω SST紊流模式及正常人吸氣量Q=5×〖10〗^(-4) m^3/s為入口條件，比較此3種時期上呼吸道之窄縮率、吸氣壓差、最小截面積處之壁剪應力的異同，進而判斷虛擬手術方法之可靠性。在研究中發現患病診斷標準的新參數──噴流擴張角(turbulence jet angle)，經過手術後的呼吸道其噴流擴張角會大幅降低，相較於手術前呼吸道之噴流擴張角小於40%以上。
本研究最後歸納出一組在21<BMI<23內之通用肌肉材料係數，使用平均後之肌肉材料參數作為虛擬手術資訊設定時，所得到呼吸道相較於手術前之呼吸道亦有展現出治療成功之效果，此效果與病患實際接受手術後呼吸道之治療相比，在窄縮率、吸氣壓差、最小截面積處之壁剪應力及噴流擴張角誤差分別為3%、3%、7%、5%，顯示本文所提出之虛擬手術新方法與流程對醫師預測手術後之狀況具參考價值。

Numerical method is employed to simulate the muscle material characteristics of obstructive sleep apnea (OSA) patients. A set of averaged muscle material characteristics for the range of body mass index (BMI) examined is concluded to predict the expansion of the patient’s upper airway after surgery for the clinic reference before the surgery. Firstly, the mandibular bone, chin, neck and upper airway models of three patients, whose BMI are similar, are reconstructed based on the computed tomography (CT) images before and after surgery. Then, the model structures before and after “virtual surgery” are simulated by computational solid mechanics (CSM) with the assumptions of elasticity, anisotropy and homogeneous muscle material characteristics. Iterations are subsequently performed through comparing the model outlines obtained by “virtual surgery” simulation and the clinical surgery to acquire the appropriate muscle material characteristics of patients. A set of proper muscle material characteristics of patients is thus attained for 21<BMI<23. On the other hand, the flow structures and pressure lose of upper airway both before and after clinical surgery as well as after “virtual surgery” are investigated and compared using computational fluid dynamics (CFD) with k-ωSST model at a flow rate 5×〖10〗^(-4) m^3/s of healthy persons. The results of CSM “virtual surgery” and CFD simulations show that the average differences of upper airway narrow rate and total inhaling pressure drop are 2.1% and 4.1% respectively. It suggests that the new proposed CSM “virtual surgery”-CFD together with the “working procedure” is able to provide useful clinical reference for the condition of upper airway after surgery.

摘要(Abstract) I
誌謝 IV
目錄 V
圖表目錄 VIII
符號 XI
第一章 前言 1
1-1 研究動機 1
1-2 文獻回顧 4
1-2-1 OSA診斷與分類 4
1-2-2 使用流體力學檢測 6
1-2-3 治療前後的比較 8
1-2-4 呼吸道與周圍組織的相關模擬 10
1-3 文獻總結 10
1-4 研究目的 11
第二章 研究方法 17
2-1 影像重建與校正 18
2-2 統御方程式 19
2-2-1 固體部分 19
2-2-2 流體部分 20
2-3 紊流模式 21
2-3-1 k-ε紊流模式 22
2-3-2 k-ω紊流模式 23
2-3-3 SST紊流模式 24
2-3-4 近壁面之流場模擬 26
2-4 數值方法 28
2-4-1 固體部分 28
2-4-2 流體部分 30
2-5 問題描述與邊界條件 31
2-5-1 固體部分 32
2-5-2 流體部分 33
2-6 格點獨立測試 34
第三章 結果與討論(1)-虛擬手術 45
3-1 虛擬手術方法與外型驗證 45
3-2 虛擬手術方法之CFD參數驗證 49
3-3 虛擬手術方法之噴流擴張角驗證 53
第四章 結果與討論(2)-虛擬手術使用平均材料參數之探討 79
4-1 肌肉材料參數之探討 79
4-2 平均材料參數之窄縮率與CFD參數驗證 81
第五章 結論與未來建議 87
5-1 結論 87
5-2 未來建議 88
參考文獻 90

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