中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (5): 795-803.doi: 10.12307/2023.979
• 生物材料综述 biomaterial review • 上一篇 下一篇
刘 闯1,2,单 烁3,于腾波3,周 欢2,杨 磊2
收稿日期:
2022-11-07
接受日期:
2023-02-14
出版日期:
2024-02-18
发布日期:
2023-08-17
通讯作者:
周欢,博士,副研究员,硕士生导师,河北工业大学生命科学与健康工程学院,健康科学与工程研究中心,河北省生物医学材料与智能诊疗重点实验室,天津市 300131
于腾波,博士,教授,主任医师,副院长,青岛大学附属医院运动医学科,山东省青岛市 266100
杨磊,博士,教授,博士生导师,院长,河北工业大学生命科学与健康工程学院,健康科学与工程研究中心,河北省生物医学材料与智能诊疗重点实验室,天津市 300131
作者简介:
刘闯,男,1997年生,河南省驻马店市人,汉族,硕士,主要从事生物材料和医疗器械等相关研究。
单烁,男,1995年生,北京市人,汉族,硕士,主要从事运动医学等相关研究。
基金资助:
Liu Chuang1, 2, Shan Shuo3, Yu Tengbo3, Zhou Huan2, Yang Lei2
Received:
2022-11-07
Accepted:
2023-02-14
Online:
2024-02-18
Published:
2023-08-17
Contact:
Zhou Huan, PhD, Associate researcher, Master’s supervisor, Center for Health Science and Engineering, Hebei Key Laboratory of Biomaterials and Smart Theranostics, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin 300131, China
Yu Tengbo, PhD, Professor, Chief physician, Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong Province, China
Yang Lei, PhD, Professor, Doctoral supervisor, Center for Health Science and Engineering, Hebei Key Laboratory of Biomaterials and Smart Theranostics, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin 300131, China
About author:
Liu Chuang, Master, School of Materials Science and Engineering, Hebei University of Technology, Tianjin 300131, China; Center for Health Science and Engineering, Hebei Key Laboratory of Biomaterials and Smart Theranostics, School of Health Sciences and Biomedical Engineering, Hebei University of Technology, Tianjin 300131, China
Shan Shuo, Master, Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao 266100, Shandong Province, China
Supported by:
Key Research and Development Program of Ministry of Science and Technology, No. 2020YFC1107400 (to YL, ZH [project participant]); National Natural Science Foundation of China for Distinguished Young Scholars, No. 82025025 (to YL); National Natural Science Foundation of China for Youth, No. 31802022 (to YTB [project participant]); Natural Science Foundation of Hebei Province of China (Green Channel Project), No. C2021202003 (to ZH); Innovation Research Group Project of Science Foundation of Hebei Province, No. H2022202007 (to YL); Tianjin Multi-Input Fund Project (General Project), No. 21JCYBJC01030 (to ZH); National Center for Orthopedics and Exercise Rehabilitation Clinical Medicine Innovation Fund Project, No. 2021-NCRC-CXJJ-ZH-17 (to YL, ZH [project participant])
摘要:
文题释义:
骨蜡:是骨科手术、胸外科手术及牙科手术中常用的骨科止血填塞剂。它主要是由蜂蜡和凡士林等软化剂或石蜡与棕榈酸异丙酯的混合物组成,其不可降解,具有较强的疏水性。手术中使用时,先放入手心稍作升温后,即可任意搓揉和塑形,并可填塞到骨渗血处实现物理封堵止血。
背景:骨蜡是可用于骨止血的填塞剂,国内外虽一直在修正骨蜡配方,但无法改变其难以被吸收的核心瓶颈,因此开发具有止血、成骨和抗菌等功能化的骨科止血材料替代骨蜡具有迫切的临床需求。
目的:回顾包括骨蜡和其替代材料在内的骨科止血材料的发展历程。结果与结论:为替代传统骨蜡,研究人员从止血、成骨等实际场景的需求出发,开发出各式骨科止血材料,但相关研究多集中于基础的理化和性能测试,缺乏系统的评价体系,同时欠缺足够的大动物实验和临床试验报道。因此,目前骨蜡依旧是公认的骨科止血材料,其根本原因是已有材料的设计无法适时满足术中止血、术后成骨及临床上的新需求。未来还需要对现有止血和成骨材料的结构、组分和功能进行整合和再设计,以满足不断提高的止血与成骨需求。
https://orcid.org/0000-0002-3918-6223(刘闯)
中国组织工程研究杂志出版内容重点:生物材料;骨生物材料;口腔生物材料;纳米材料;缓释材料;材料相容性;组织工程
中图分类号:
刘 闯, 单 烁, 于腾波, 周 欢, 杨 磊. 骨科止血材料临床应用的优势、不适与面临的挑战[J]. 中国组织工程研究, 2024, 28(5): 795-803.
Liu Chuang, Shan Shuo, Yu Tengbo, Zhou Huan, Yang Lei. Advantages, discomfort and challenges of clinical application of orthopedic hemostatic materials[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(5): 795-803.
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1.1.7 检索策略 见图2。
1.2 入选标准
1.3 质量评估 通过计算机初检得到680篇文献,经资料收集者互相评估纳入文献的有效性和适用性,通过阅读文献题目和相关摘要进行初步筛选;排除中、英文文献重复性研究及内容不相关的文献,最终筛选出符合标准的136篇文献进行综述,其中中文文献45篇,英文文献91篇,具体见图3。
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文题释义:
骨蜡:是骨科手术、胸外科手术及牙科手术中常用的骨科止血填塞剂。它主要是由蜂蜡和凡士林等软化剂或石蜡与棕榈酸异丙酯的混合物组成,其不可降解,具有较强的疏水性。手术中使用时,先放入手心稍作升温后,即可任意搓揉和塑形,并可填塞到骨渗血处实现物理封堵止血。该文系统回顾了以骨蜡为代表的骨科止血材料的需求和转化应用瓶颈。骨髓腔内毛细血管损伤造成的骨组织出血是骨科领域的常见症状,出血不仅影响患者的生命安全,也会一定程度干扰医生的手术视野。骨蜡是临床经典的骨科止血材料,但存在骨不愈合、移位、感染等众多并发症。研发新型的骨科止血材料是国内外新兴热点,但是迄今并没有获得突破性进展,新材料的临床接受度普遍不高,究其原因在于替代材料无法满足术中止血、术后成骨及不改变医生手术习惯的需求。同时,当前的骨科止血材料的产品注册转化缺少公认的评价体系,其在NMPA的注册体系中缺乏明确的定位和系统性的评价准则,这也在一定程度上给骨科止血材料的研究转化提出了挑战。
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