组织工程学技术在尿道狭窄中的应用

Application of tissue engineering technology in urethral stenosis

背景:由于尿道狭窄的治疗中缺乏理想的尿道修复及重建材料,疗效均不满意。组织工程技术在尿道修复重建的应用近年来发展迅速,因此寻求理想的尿道狭窄修复替代材料成为了当前研究的热点。目的:总结并探讨组织工程技术的发展及在尿道狭窄修复中的应用。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(1989/2009)数据库,检索词分别为"尿道修复,组织工程,干细胞"和"tissue engineering,urethra engineering,BMMSCs",语言分别设定为中文和英文。主要从干细胞技术,生物支架材料以及自体组织器官的构建3个方面对组织工程技术进行尿道狭窄修复重建做了阐述。从国内外最新研究及临床应用两方面进行总结,着重评价基础研究和临床应用的效果。结果与结论:共检索到96篇文章,按纳入和排除标准对文献进行筛选,共纳入30篇文章。干细胞技术对于长期的尿道狭窄修复重建在疗效评估欠缺较可靠的证据,生物支架材料作为新兴材料,具有良好的组织相容性,在临床应用中已经取得了较好效果。尿道组织化器官的构建对于尿道狭窄修复重建长期的疗效缺乏有效的评估。结果表明生物支架材料用于尿道狭窄的修复重建时效果较好,而干细胞技术和尿道狭窄修复重建治疗尿道狭窄时,其疗效评估欠缺可靠的证据。

BACKGROUND：The therapeutic effect of the treatment of urethral stricture is unsatisfactory due to lack of ideal materials for urethral repair and reconstruction.The application of tissue engineering technology develops quickly in recent years.Thus,it becomes to a hot topic to seek optimal repair and reconstruction materials.OBJECTIVE：To summarize the development of tissue engineering technology and to explore its application in repairing urethral stricture.METHODS：A computer-based online search was performed by the first author on the Chinese Journal Full-text Database（CNKI：1989 to 2009） and Medline database（1989 to 2009） using Key words of ＂tissue engineering,urethra engineering,BMMSCs＂.The languages were limited in Chinese and English.The urinary tract repair and reconstruction were explained from the aspects of stem cells,biomaterial scaffold and construction of autografts.The paper summarized the urethra engineering from theoretical studies and clinical application,emphasized on the evaluation of application results. RESULTS AND CONCLUSION：A total of 96 articles are retrieved.According to inclusion and exclusion criteria for literature selection,30 papers were included.Stem cell technology was lack of reliable evidences in evaluating long-term effects of urethral stricture repair and reconstruction.As an emerging material,biomaterial scaffold has excellent histocompatibility,and has received good results in clinical application.There was lack of effective evaluation of urethral stricture repair and reconstruction using urethra organized organs.The results demonstrated that biomaterial scaffold obtains good results in repair and reconstruction of urethral stricture,but the long-term results of other technology need to be verified.