中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (34): 6421-6424.doi: 10.3969/j.issn.1673-8225.2010.34.037

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

生物补片在女性盆底重建应用中的生物相容性

李冬梅   

  1. 张家口市妇幼保健院妇产科，河北省张家口市    075000
  • 出版日期:2010-08-20 发布日期:2010-08-20
  • 作者简介:李冬梅，1964年生，河北省张北县人，汉族，1988年张家口医学院毕业，副主任医师。 zjkswj2008@126.com

Biocompatibility of biological patch in female pelvic floor reconstruction

Li Dong-mei   

  1. Department of Obstetrics and Gynecology, Zhangjiakou Maternal and Child Health Hospital, Zhangjiakou   075000, Hebei Province, China
  • Online:2010-08-20 Published:2010-08-20
  • About author:Li Dong-mei, Associate chief physician, Department of Obstetrics and Gynecology, Zhangjiakou Maternal and Child Health Hospital, Zhangjiakou 075000, Hebei Province, China zjkswj2008@126.com

PDF

489

被引次数

15

摘要：

背景：生物补片是重要的盆底组织替代物，能够替代薄弱受损的盆底筋膜组织，在盆底重建中的应用越来越广泛。但其疗效及生物相容性研究却少有报道。
目的：介绍生物补片在女性盆底重建中的临床应用进展，评价各种材料的补片与宿主的生物相容性。
方法：由第一作者用计算机检索中国期刊全文数据库(CNKI：1990/2010)和Medline database(1990/2010)，检索词分别为“补片，妇产科疾病，治疗”和“obstetrics，gynecology diseases，treatment”，语言分别设定为中文和英文。最终纳入26篇符合标准的文献，分别以补片在女性盆底重建中的临床应用进展以及补片植入后的生物相容性和并发症两方面进行总结。
结果与结论：补片植入主要用于治疗女性盆底功能障碍性疾病，包括全盆腔重建，阴道前、后壁修补和阴道穹窿骶骨悬吊等，疗效较好。在各种类型植入物中，自体组织、同种异体移植物、异种移植物植入后易感染，磨损，生物相容性较差，作为重建材料并不合适。合成的可吸收补片材料坚固，应用方便，但可能发生感染、排斥和侵蚀等并发症，生物相容性较差。合成的不可吸收补片和脱细胞补片感染发生率低，并发症少，生物相容性较好。补片植入时尽量将生物补片置于无张力状态，无菌操作，要避免任何永久性的缝线穿透阴道黏膜、严密止血，即可降低并发症发生率。

关键词: 生物补片, 妇产科疾病, 盆底重建, 生物相容性, 并发症

Abstract:

BACKGROUND: The biological patch is an importance substitute of the pelvic floor tissue, it that can replace damaged weak pelvic fascia, has been more and more widely used in pelvic floor reconstruction. However, the efficacy and biocompatibility are rarely reported.
OBJECTIVE: To introduce clinical application progress of biological patch in female pelvic floor reconstruction, and to evaluate the biocompatibility of various patch materials with the host.
METHODS: A computer search was performed by the first author in China Academic Journal Full-text Database (CNKI: 1990/2010) and Medline database (1990/2010), using the key words of “patch, obstetrics and gynecology diseases, treatment” in Chinese and “obstetrics, gynecology diseases, treatment” in English. Eventually 26 in accordance with the inclusive criteria were included and summarized at the following two aspects: clinical application progress of the patch in female pelvic floor reconstruction, and both biocompatibility and complications after patch implantation.
RESULTS AND CONCLUSION: The patch implantation mainly shows good effects in treatment of female pelvic floor dysfunction diseases, including full pelvic reconstruction, vaginal anterior and posterior wall repair, and vaginal vault suspension. In all types of implants, autologous tissue, allografts, xenografts are vulnerable to infection and wear after implantation, with poor biocompatibility, so they are not suitable as the reconstruction materials. The synthetic absorbable patch is strong and convenient, but prone to infection, rejection, erosion and other complications, with poor biocompatibility. The non-absorbing synthetic patch and acellular patch show a lower infection rate, fewer complications, and better biocompatibility. In patch implantation, biological patch should be free from tension state, and be manipulated at aseptic conditions, avoiding any permanent sutures through the vaginal mucosa and closely stop bleeding, thus reducing the incidence of complications.

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