生物止血敷料及纱布在外科伤口中的应用评价  

Evaluation of biological hemostatic dressings and gauzes in surgical wounds

作　　者：周忠笑[1] 魏晰麟[1] 姚建茹[2] 张健[1] 边刚[1] 李金晖[1] 

机构地区：[1]沈阳医学院奉天医院普外三科,辽宁省沈阳市110024 [2]沈阳医学院奉天医院中央手术室,辽宁省沈阳市110024

出　　处：《中国组织工程研究与临床康复》2010年第51期9635-9638,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:近年来,随着生物医用高分子材料如纤维素、甲壳素等天然高分子材料以及聚乙烯醇、胶原等合成高分子材料的研发,多种外科止血生物材料应用于临床。目的:评价不同生物止血敷料及纱布的材料学性能及应用于外科伤口的生物相容性,寻找符合不同伤口创面需要的止血材料。方法:以"生物材料,止血敷料,纱布,胶原/壳聚糖,生物相容性"为中文关键词;以:"biomaterial;hemostatic material;bioresorbable material;hemostasis effect;hemostatic mechanism"为英文关键词,采用计算机检索2000-01/2010-06相关文章。纳入与生物敷料、纱布在伤口止血方面应用及这些材料与人体相容性的文章;排除重复研究或Meta分析类文章。以33篇文献为主重点进行讨论不同生物止血材料性能及生物相容性。结果与结论:近几年国内外生物医用可吸收止血材料主要包括纤维蛋白胶、壳聚糖、明胶海绵、氰基丙烯酸酯类组织胶、氧化纤维素和氧化再生纤维素等。各种止血性伤口急救材料都有各自的特点,但在临床应用的选择上,应考虑多方面因素,包括手术部位、出血部位、伤口形态大小、不同渗/出血情况的填塞要求、不同止血材料的自身性能及与机体的相容性等。但因目前尚无完全符合理想标准的材料,因此开发新的快速止血和与宿主相容性良好的止血材料及复合材料势在必行。OBJECTIVE：To evaluate the performance and application prospects of hernia patch materials,and to look for a reasonable hernia repair material.METHODS：Wanfang database （http：//www.wanfangdata.com.cn/） from January 1999 to December 2009 was retrieved on computer for articles related with the biomaterials used in hernia repair,using keywords of ＂tissue engineering,abdominal hernia,biomaterials＂ in Chinese.The repeated study,general review or Meta analysis were excluded,totally 25 articles were involved in evaluation.RESULTS：The traditional non-degradable biomaterials are only be used as hernia filling materials,with the development of medicine and tissue engineered techniques,various synthetic biomaterials have emerged.Currently used hernia repair materials include non-absorbing materials such as polypropylene,and absorbable material,such as polyglycolic acid mesh and composite materials.Through the stimulation between the organism and the patch,these materials produce different reactions,alternative repair materials may occur in future,that is to repair various wounds according to different materials.It is one of hot spots in research of biomedical engineering that to use autologous cells and dermal materials to complete hernia repair.CONCLUSION：Although polypropylene and polyglycolic acid mesh are commonly applied in clinical practice for hernia repair,hernia repair materials need further development because of their inevitable shortcomings.

关 键 词：生物材料 止血 敷料 纱布 胶原/壳聚糖 纳米 生物相容性 

分 类 号：R318[医药卫生—生物医学工程]