补片在妇产科疾病中的临床应用及其生物相容性

Clinical application and biocompatibility of patches in obstetrics and gynecology diseases

目的:介绍补片在妇产科疾病中的临床应用进展,评价各种材料的补片与宿主的生物相容性。方法:由第一作者用计算机检索中国期刊全文数据库(CNKI:1989/2009)和Medline database(1989/2009)数据库,检索词分别为"补片,妇产科疾病,治疗"和"obstetrics,gynecology diseases,treatment",语言分别设定为中文和英文。共检索到53篇文章,按纳入和排除标准对文献进行筛选,共纳入23篇文章。分别以补片在妇产科疾病的临床应用进展和各种补片植入后的生物相容性和并发症两方面进行总结。结果:补片在女性盆底功能障碍性疾病中的应用较为广泛,主要应用于全盆腔重建,阴道前、后壁修补和阴道穹窿骶骨悬吊等,操作简便,疗效较好。目前的重建材料有自体组织、同种异体移植物、异种移植物、合成的不可吸收补片、合成的可吸收补片、脱细胞补片等,各有其优缺点。补片最常见的并发症是感染和侵蚀,尽量将生物补片置于无张力状态,可降低并发症的发生率。结论:补片植入主要用于治疗女性盆底功能障碍性疾病,疗效较好。在各种类型补片中,合成的不可吸收补片和脱细胞补片感染发生率低,并发症少,生物相容性好于其他类型补片。补片植入操作时尽量将生物补片置于无张力状态,严格无菌操作,严密止血即可降低感染和侵蚀的发生率。

OBJECTIVE： To introduce the clinical application advances of patch in obstetrics and gynecology diseases and evaluate the biocompatibility of various patches and host. METHODS： A computer-based online search of CNKI （1989/2009） and Medline database （1989/2009） was performed using the key words of “patch, obstetrics and gynecology diseases, treatment” in Chinese and “obstetrics and gynecology diseases, treatment” in English. A total of 53 articles were collected, and 23 were selected according to inclusion and exclusion criteria. The content concerning clinical application advances of patch in obstetrics and gynecology diseases and the biocompatibility and complications of various patches was summarized. RESULTS： Patch has been widely used in treating female pelvic floor dysfunction, including total pelvic cavity reconstruction, anterior and posterior vaginal wall repair and vagina fornix sacral suspension. It is simple and effective. Currently, the reconstruction materials include autologous, allograft, xenograft, synthesized nonabsorbable and absorbable patches, and acellular patch. They have specific advantages and disadvantages. Common complications of patch include infection and erosion. The tension-free patch reduces incidence of complications. CONCLUSION： Patch implants have been mainly used for female pelvic floor dysfunction, showing favorable effect. Of various patches, synthesized nonabsorbable patch and acellular patch display low infection, little complication and good biocompatibility. Tension-free and aseptic patches, and effective hemostasis effectively decrease incidence of infection and erosion.