中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (30): 4848-4854.doi: 10.3969/j.issn.2095-4344.1477

• 生物材料综述 biomaterial review • 上一篇    下一篇

骨组织工程技术治疗感染性骨缺损：优势与问题

占华松1，陈跃平2，章晓云2 
  

  1. 1广西中医药大学，广西壮族自治区南宁市  530001；2广西中医药大学附属瑞康医院创伤骨科与手外科，广西壮族自治区南宁市  530011
  • 收稿日期:2019-05-13 出版日期:2019-10-28 发布日期:2019-10-28
  • 通讯作者: 陈跃平，博士生导师，主任医师，广西中医药大学附属瑞康医院创伤骨科与手外科，广西壮族自治区南宁市 530011
  • 作者简介:占华松，男，1991年生，江西省九江市人，广西中医药大学在读硕士，主要从事骨与关节疾病及运动损伤方面的研究。
  • 基金资助:

    国家自然科学基金资助项目(81760796)，项目负责人：陈跃平；广西自然科学基金课题(2015GXNSFAA139136)，项目负责人：陈跃平；广西高校中青年教师科研基础能力(2019KY0352)，项目负责人：章晓云；2017年广西中医药大学校级培养学科-骨外科学建设项目(04B2017082)，项目负责人：陈跃平

Bone tissue engineering in infectious bone defect: advantages and problems

Zhan Huasong1, Chen Yueping2, Zhang Xiaoyun2
  

  1. 1Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2Department of Traumatic Orthopedics and Hand Surgery, Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • Received:2019-05-13 Online:2019-10-28 Published:2019-10-28
  • Contact: Chen Yueping, Doctoral supervisor, Chief physician, Department of Traumatic Orthopedics and Hand Surgery, Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • About author:Zhan Huasong, Master candidate, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81760796 (to CYP); the Natural Science Foundation of Guangxi Zhuang Autonomous Region of China, No. 2015GXNSFAA139136 (to CYP); the Basic Research Ability of Young and Middle-aged Teachers in Colleges and Universities of Guangxi Zhuang Autonomous Region of China, No. 2019KY0352 (to ZXY); the Training Subject-Osteosurgery Construction Project of Guangxi University of Chinese Medicine in 2017, No. 04B2017082 (to CYP)

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摘要：

文章快速阅读：

 

文题释义：
感染性骨缺损：是同时兼备骨感染及骨缺损病因病变，多由高能量损伤所致的复杂开放性及严重性骨及软组织部分缺损改变，若治疗时机及方法失当常易诱发感染，病程迁延形成慢性骨髓炎，从而导致感染性骨缺损，治疗周期及病程漫长，常易引起肢体功能障碍，已成为骨科临床常见慢性病及难题。
Ilizarov技术：Ilizarov骨搬移技术依照张力-应力法则，由俄罗斯Ilizarov医师于20世纪50年代首次提出，通过牵拉反复刺激促进软组织及骨组织再生、修复和重塑，是骨缺损治疗行之有效的手段。
 
 
背景：随着现代技术及医疗水平的不断提高，用于治疗感染性骨缺损的途径虽然逐渐增多，然而困扰的难点却依然是缺少一种兼备抗感染、诱导骨折再生修复和可生物降解材料为一体的复合体，用于达到一期治疗目的措施；这也是未来医疗工作者奋进的目标和动力。
目的：探讨骨组织工程技术治疗感染性骨缺损的应用及前景。
方法：检索PubMed、MEDLINE、万方、中国知网、维普及中国生物医学文献数据库2013至2019年相关国内外文献，内容包括：①局部抗生素临床运用及研究文献；②缓释系统治疗骨感染的实验研究文献；③生物支架材料在大段骨缺损中应用的临床及实验研究文献；④骨组织工程在修复感染性骨缺损中的应用及发展文献；⑤3D打印技术相关文献。共纳入60篇文献分析总结。
结果与结论：①骨感染部位抗生素局部使用疗效可观；②骨组织工程在诱导骨再生修复骨缺损治疗中具有远大发展前景及潜力，为未来骨科医生治疗感染性骨缺损开辟了新道路，也给患者及其家属带来新希望，而探索最合适的优质种子细胞成为该项技术的突破点及挑战；③探索骨组织工程技术、抗菌药物和可吸收性生物材料完美契合的新技术治疗感染性骨缺损，是未来骨科临床治疗感染性骨缺损的全新发展方向。

关键词: 骨组织工程, 生物材料, 感染性骨缺损, 种子细胞, 抗菌药物, 缓释系统, 3D打印, 国家自然科学基金

Abstract:

BACKGROUND: With the continuous improvement of modern technology and medical level, although there are many ways to treat infectious bone defects, there is a lack of a viable early treatment regimen that combines anti-inflammatory, fracture healing, and biodegradable therapies, for the purpose of primary
treatment measures. This is also the goal and motivation of future medical workers.
OBJECTIVE: To investigate the application and prospect of bone tissue engineering in the treatment of infectious bone defects.
METHODS: PubMed and MEDLINE database, WanFang, CNKI, VIP and CBM database were searched from 2013 to 2019 for relevant domestic and foreign literatures, including: (1) clinical application and research literature of local antibiotics; (2) experimental study on sustained release system (DDS) for the treatment of bone infection; (3) clinical and experimental literature on biological scaffold materials in large bone defects; (4) application and progress of bone tissue engineering in the repair of infectious bone defects; (5) literature on 3D printing technology. A total of 60 literature analyses and summaries were included.
RESULTS AND CONCLUSION: (1) The local use of antibiotics at bone infection site was effective. (2) Bone tissue engineering had a great development prospect and potential in inducing bone regeneration to repair bone defects, which also pointed out a new way for orthopedic surgeons to treat infectious bone defects in the future, and gave new hope to patients and their families. The breakthrough and challenge of this technology is to explore the most suitable high-quality cells. (3) To explore the perfect combination of bone tissue engineering technology, antimicrobial agents and absorbable biomaterials for the treatment of infectious bone defects with new technologies is a new development direction of the orthopedic clinical treatment for infectious bone defect in the future.

Key words: bone tissue engineering, biomaterials, infectious bone defect, seed cells, antibiotics, sustained-release system, 3D printing, National Natural Science Foundation of China

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