中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (2): 272-277.doi: 10.3969/j.issn.2095-4344.1514

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

防治手术后腹腔粘连屏障材料：生物特性及优势与不足

杨丽丽1，2，卞尧尧3，赵 敏1，王叶同3，唐升进3，李文林2，曾 莉1，2   

  1. 1南京中医药大学第一临床医学院，江苏省南京市 210023；2南京中医药大学敬文图书馆，江苏省南京市 210023；3南京中医药大学护理学院，江苏省南京市 210023
  • 收稿日期:2018-09-03 出版日期:2019-01-18 发布日期:2019-01-18
  • 通讯作者: 曾莉，教授，博士生导师，南京中医药大学第一临床医学院，江苏省南京市 210023；南京中医药大学敬文图书馆，江苏省南京市 210023
  • 作者简介:杨丽丽，女，1986年生，江苏省南通市人，汉族，南京中医药大学在读博士，馆员，主要从事中医药防治术后腹腔粘连研究。
  • 基金资助:

    国家自然科学基金(81704084，项目负责人：杨丽丽；81373843，项目负责人：曾莉；81673982，项目负责人：
    曾莉)；江苏省中医药局科技项目(YB2017002，项目负责人：杨丽丽；YB2015002，项目负责人：李文林)；2018
    年江苏省研究生科研与实践创新计划(面上项目)(7，项目负责人：杨丽丽)；南京中医药大学2017 年大学生创新
    创业训练课题(16，项目负责人：唐升进、王叶同)

Barrier materials for postoperative abdonimal adhesion: biological characteristics, merits and demerits

Yang Lili1, 2, Bian Yaoyao3, Zhao Min1, Wang Yetong3, Tang Shengjin3, Li Wenlin2, Zeng Li1, 2   

  1. 1First Clinical Medicine College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; 2Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; 3School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
  • Received:2018-09-03 Online:2019-01-18 Published:2019-01-18
  • Contact: Zeng Li, Professor, Doctoral supervisor, First Clinical Medicine College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
  • About author:Yang Lili, Doctorate candidate, First Clinical Medicine College, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China; Jingwen Library, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81704084 (to YLL), 81373843 (to ZL), and 81673982 (to ZL); the Science
    and Technology Projects of Jiangsu Provincial Bureau of Traditional Chinese Medicine, No. YB2017002 (to YLL), YB2015002 (to LWL); the
    2018 Graduate Research and Practice Innovation Program of Jiangsu Province (General Program) No. 7 (to YLL); the Innovation and
    Entrepreneurship Training Project of Nanjing University of Chinese Medicine in 2017, No. 16 (to TSJ and WYT)

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摘要：

文章快速阅读：

 

文题释义：
腹腔粘连：为外科术后大网膜、腹腔脏器和腹壁之间的病理性连接，是腹部手术后常见并发症，临床症状多表现为肠梗阻、慢性腹痛、女性不孕不育等，不但增加了二次手术率，延长了住院时间，而且给患者及其家庭带来沉重的疾病负担和经济负担。
理想的防粘连屏障材料：具有良好的生物相容性；具有适宜的组织黏附性(不需缝合)；能完全覆盖创伤表面，并且具有足够的体内存留时间；能降解吸收而不需二次手术将其取出；既能有效防止粘连形成又不影响伤口的正常愈合；具有一定的机械强度，便于实施操作等。
 
 
背景：术后腹腔粘连是亟待解决的外科问题之一，针对复杂的术后粘连病理机制及众多危险因素，手术技巧及屏障材料日趋成为术后预防粘连研究的关注点。
目的：概述术后粘连病理机制及危险因素，综述不同制剂类型屏障材料的来源、生物特性、研究现状及潜在不足等。
方法：通过计算机检索PubMed、CNKI数据库、万方数据库和维普数据库入库至2018年1月的相关文章，设定“术后腹腔粘连、病因病机、相关因素、防治措施、屏障材料”和“postoperative abdominal adhesion、pathological mechanism、risk factors、preventive measures、barrier materials”为检索词，最后纳入54篇文献进行分析讨论。

结果与结论：防粘连材料能够通过物理屏障在粘连形成的早期阶段隔离受创区域和外周组织，防止腹腔粘连形成。目前防粘连屏障材料主要存在溶液剂、凝胶剂及膜剂3种剂型，每种材料均有自身的优势与不足，因此针对目前不足深入研究术后腹腔粘连病理过程，预测术后粘连的危险因素，术中提高手术技巧，根据实际情况选择合适的防粘连屏障材料，有望减少术后腹腔粘连的形成。

ORCID: 0000-0001-5220-3094(杨丽丽)

关键词: 术后腹腔粘连, 病因病机, 相关因素, 防治措施, 屏障材料, 生物材料

Abstract:

BACKGROUND: Postoperative abdominal adhesion is one of the most urgent surgical problems. In view of the complicated pathological mechanisms and various risk factors of postoperative adhesion, surgical techniques and barrier materials have increasingly become the focus of postoperative prevention of adhesion.

OBJECTIVE: To summarize the pathological mechanisms and risk factors of postoperative abdominal adhesions and to review the material source, biological characteristics, current research status, and potential deficiencies of different types of barrier materials.
METHODS: We retrieved PubMed, CNKI, WanFang and VIP databases from their inception dates to January 2018, and “postoperative abdominal adhesion, etiology and pathogenesis, risk factors, preventive measures, barrier materials” were used as the keywords in English and Chinese, respectively. Fifty-four articles were included in final analysis.

RESULTS AND CONCLUSION: Anti-adhesion materials can isolate the injured area and peripheral tissues through physical barriers in the early stage of adhesion formation, and thus prevent the formation of abdominal adhesion. There are three types of anti-adhesion barrier material at present, including solution, gel and membrane agents. Each kind of material has its own advantages and disadvantages. Therefore, we explore the pathological process of postoperative abdominal adhesions, predict the risk factors of postoperative adhesions, improve surgical skills and select appropriate anti-adhesion barrier materials according to actual conditions, which are expected to reduce the formation of postoperative abdominal adhesions.

Key words: Tissue Adhesions, Postoperative Complications, Tissue Engineering

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