人工胆管替代物的设计与发展

Design and development of substitute for the bile duct

目的:综合分析人工胆管设计和发展的最新进展。资料来源:通过计算机检索OVID数据库1966-01/2006-10有关人工胆管的文献,检索词“artificial bile duct”,限定文章语言种类为English。同时检索1994-01/2006-10中国全文期刊数据库有关人工胆管的文献,检索词“人工胆管”,限定文章语言种类为中文。资料选择:选择与人工胆管相关的研究对比、经验总结、最新进展等文献,力求资料全面,排除重复研究。资料提炼:共收集相关国内外文献51篇,排除重复性研究19篇,采用32篇。其中关于人工胆管研究背景6篇,自体移植5篇,纳米技术相关2篇,干细胞技术相关5篇,机械胆管结构1篇,高分子材料2篇,最新进展11篇。资料综合:胆道手术一直是外科手术的难点,术后易发生胆管狭窄、反复胆道逆行感染乃至胆汁性肝硬化等并发症,长期以来,人们一直在追求设计一种人工胆管来解决胆道修复与重建的难题。在自体移植、机械结构、纳米技术、干细胞技术和组织工程高分子材料等方面分别取得了各自进展。目前更加倾向于组织工程高分子材料。结论:人工胆管的设计研究虽然在多个方面获得进展,但因自体移植、机械结构、纳米技术以及干细胞技术各自存在难以克服的弊端和限制,使其无法获得突破性成果,组织工程高分子材料成为人工胆管设计的主要方向。

OBJECTIVE： This paper is aimed to summarize the latest progress of the design and improvement of artificial bile duct. DATA SOURCES： A computer-based online search of OVID database was undertaken to identify articles about artificial bile duct published in English from January 1966 to October 2006 with keyword of ＂artificial bile duct＂. Meanwhile, Chinese articles about artificial bile duct published from January 1994 to October 2006 were retrieved in China National Knowledge infrastructure （CNKI）, and the keyword was artificial bile duct in Chinese. STUDY SELECTION： The literatures of comparative study, experience summary and the latest progress were retrieved to obtain the overall data. Repetitive studies were deleted. DATA EXTRACTION： Total 51 articles about artificial bile duct were collected, 19 repetitive studies were deleted, and 32 were involved, including 6 about background, 5 about autotransplantation, 2 about nanotechnology, 5 about stem cell technique, 1 about mechanical bile duct, 2 about macromoiecular material, and 11 about the latest progress. DATA SYNTHESIS： The operation of bile duct has always been the most difficult part in the general surgery. The patients have a high morbidity of the post-operation complication, such as bile duct stenosis, repeated biliary tract infection, and even biliary hepatocirrhosis. Therefore, we＇re seeking for some kind of artificial bile duct to solve the problem in bile duct＇s repair and reconstruction. The development in autotransplantation, mechanical structure, nanotechnology, stem cell technique and tissue-engineered macromolecule material has been retained. So far, the tissue-engineered macromolecule material is the best one. CONCLUSION： There have been great progresses in research of artificial bile duct, however, there＇s no significant achievement because of the inextricable shortcomings and limits in autotransplantation, mechanical structure, nanotechnology and stem cell technique. Therefore, the tissue-engineered macromolecule material has become the best material for artificial bile duct.