脱细胞真皮基质在临床治疗中的应用  

Clinical application of acellular dermal matrix

作　　者：朱柯颖 郭瑢 陈德滇[1] 黄胜 Zhu Keying;Guo Rong;Chen Dedian;Huang Sheng(Third Affiliated Hospital of Kunming Medical University,Kunming 650118,Yunnan Province,China)

机构地区：[1]昆明医科大学第三附属医院,云南省昆明市650118

出　　处：《中国组织工程研究》2022年第34期5512-5517,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81860465),项目负责人:陈德滇;云南省教育厅科学研究基金项目(2020J0198),项目负责人:郭瑢。

摘　　要：背景:脱细胞真皮基质作为皮肤替代物具有广阔的前景和市场。目的:综述脱细胞真皮基质在临床上的应用进展。方法:应用计算机检索2000-2021年CNKI、PubMed数据库、万方数据知识服务平台,英文检索词为"Acellular dermal matrix,reconstruction/repair/plastic/clinical study",中文检索词为"脱细胞真皮基质,修复/重建/整形/临床研究",最终共纳入64篇文献进行综述。结果与结论:脱细胞真皮基质具有快速血管化、低抗原性、良好的组织相容性和稳定的理化性质等特点,是头颈外科、乳腺外科、烧伤整形外科、妇科、泌尿外科等手术中的常用生物材料。脱细胞真皮基质在临床上应用的主要问题在于其产出少、达到医用标准的生产过程复杂,因此价格高昂,增加了患者的医疗经济负担。脱细胞真皮基质虽然经过脱细胞处理去除了大部分异体抗原物质,但仍有排异、感染等手术并发症的风险。未来对于脱细胞真皮基质,首先应该从生产工艺等根源上进行优化,改良生产工艺,降低生产成本、增加商品化规格;其次,改进脱细胞过程,在保留真皮基质的前提下更深一步去除脱细胞真皮基质中蛋白质等过敏原,进一步降低脱细胞真皮基质免疫原性、增强其相容性,减少感染、排异等不良事件的发生。BACKGROUND:As a skin substitute,acellular dermal matrix has broad prospects and market.OBJECTIVE:To review the clinical application of acellular dermal matrix.METHODS:The authors searched PubMed,CNKI and Wanfang databases for articles published from 2000 to 2021 with the key words of"acellular dermal matrix,reconstruction/repair/plastic/clinical study"in English and Chinese,separately.Finally,64 articles were included for review.RESULTS AND CONCLUSION:Acellular dermal matrix,characterized by rapid vascularization,low antigenicity,good histocompatibility and stable physicochemical properties,is a commonly used biological material in operations in the head and neck surgery,breast surgery,burn plastic surgery,gynecology,and urology.The main problem lies in its low output and the complicated production process to meet the medical standards.Thus,the price of acellular dermal matrix used in clinical use is high,increasing the medical economic burden of patients.Although most of the alloantigen substances are removed,acellular dermal matrix is still a foreign material for patients,so there is still a risk of surgical complications,such as rejection and infection.For future acellular dermal matrix,it is necessary to optimize the production process,improve the production process,reduce the production cost and increase the commercial specifications.From improving the decellularization process,it further removes proteins and other allergens from the acellular dermal matrix while preserving the dermal matrix,further reduces the immunogenicity of the acellular dermal matrix,enhances its compatibility,and reduces adverse events,such as infection and rejection.

关 键 词：脱细胞真皮 真皮基质 脱细胞 皮肤替代物 临床应用 综述 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]