气管支架及人工气管材料的应用

Application of tracheal stent and artificial tracheal materials

目的:对人工气管及气管支架材料的分类性质及其在气管及支气管狭窄治疗中的应用和并发症的处理进行归纳总结。方法:第一作者应用计算机检索PubMed数据库(http://www.ncbi.nim.nih.gov/PubMed)及CNKI数据库(www.cnki.net/index.htm),在标题中以"人工气管,气管支架,生物复合材料,镍钛合金支架"或"artificialtrachea,trachealstent"为检索词进行检索,选择文章内容与气管支架材料类型,材料特点适应证选择及应用疗效相关,同一领域文献则选择近期发表或发表在权威杂志文章,共纳入10篇文章。结果:高分子聚合物材料人工气管是一种生物型复合式结构,合理地整合了既往无孔型和有孔型人工气管的优点,在防止假体滑脱、移位、漏气、网管裸露塌陷学方面具有明显优势。镍钛合金支架,其独特的网状结构设计,允许金属丝做轴向及冠向运动,因此该支架适用于不规则或表面凸凹不平的气道病变,故广泛用于各种良、恶性气道狭窄的治疗。结论:近年来随着组织工程学的兴起和发展,在生物组织工程化气管的研究方面取得了一定的进展,目前已能够以软骨细胞或骨髓间质细胞为种子细胞构建出与自体气管相近的组织工程化气管,而且能够用软骨细胞及上皮细胞构建出带有气管黏膜上皮的复合组织工程化气管,但这些组织工程化气管移植到体内能否长期具有活性、能否发挥正常的生理功能等还需要进一步的实验验证。

OBJECTIVE：To summarize the classification,features of artificial tracheal materials and application of tracheal stent in treating tracheal or bronchial stenosis,as well as the disposals for related complications.METHODS：The databases of PubMed（http：//www.ncbi.nim.nih.gov/PubMed） and CNKI（www.cnki.net/index.htm） were searched by the first author using search words of ＂artificial trachea,tracheal stent＂ both in English and Chinese.Articles about classification,materials selection,as well as the application outcomes were involved,in the same field,papers published in authoritative articles during the last three years were selected preferentially,totally 10 documents were included in this study.RESULTS：The high molecular polymer trachea possessed biotype composite structures,which combined the merits of previous artificial trachea and exhibited advantages in preventing prosthesis slippage,displacement,air leakage,as well as bare or collapse.The net structure of nick-eltitanium alloy stent allowed the axial and coronary movement of metal wire which is suitable for irregular or scraggy surfaces,thus,it was widely used in treating benign or malignant tracheobronchial stenosis.CONCLUSION：With the development of tissue engineering,some progressive achievements,such as application of seed cells and tracheal epithelial cells in constructing tissue engineered trachea,have been obtained.However,whether these tissue engineered trachea can maintain its activity and plays normal physiologic function in vivo still needs to be explored.