不同生物补片材料在盆底重建应用中的可行性

Feasibility of different biological patches in pelvic floor reconstruction

目的:探讨替代材料补片在盆底重建中的可行性和有效性及其临床价值。方法:采用电子检索的方式,在维普数据库及PubMed中检索有关盆底功能障碍、盆底重建以及补片植入物材料的应用等方面的文献,中文检索关键词为"补片,盆底重建"。英文检索关键词为"biological Patch,reconstructive pelvic surgery"。选择文章内容与补片类型、材料学特点及其应用效果相关,同一领域文献则选择近期发表或发表在权威杂志文章。排除重复研究、普通综述或Meta分析类文章,筛选纳入16篇文献进行评价。结果:生物材料补片分为自体和同种异体及异种材料。同种及异种移植材料目前多为脱细胞组织基质,其优势是不含细胞表面受体的特异识别位点,不易引发受体的免疫排斥反应,增加了组织相容性,减少了感染概率,而且可能存在某些复合生长因子,能够诱导调节细胞的生长和分化。合成材料补片也已广泛应用于临床,但可能发生感染、排斥和侵蚀等并发症。结论:生物材料补片的出现在很大程度上避免了侵蚀问题,但使用寿命、安全性及客观效果尚有争议。

OBJECTIVE：To investigate the feasibility,effectiveness and clinical value of alternative materials patch in pelvic floor reconstruction.METHODS：An online search of VIP database and PubMed database was performed to retrieve relevant articles of pelvic floor dysfunction,pelvic floor reconstruction and the application of patch implants,with key words of ＂patch,pelvic floor reconstruction＂ in Chinese and ＂biological patch,reconstructive pelvic surgery＂ in English.Articles related to patch type,materials characteristics and application were included,those recently published or published in the authority journals were preferred in the same field.Duplicated research,reviews or Meta analysis were excluded,16 articles were selected into the evaluation.RESULTS：The biomaterial patch is divided into autologous,allogeneic and xenogeneic types.The autologous and xenogeneic grafts are mostly acellular tissue matrix at present,and its advantage is that there is no specific cognition site of cell surface receptors,it is difficult to trigger receptor immune rejection,thus increasing histocompatibility and reducing the probability of infection,some compound growth factors may exist and can regulate cell growth and induced differentiation.Synthetic patch materials have also been widely used in clinical practice,but may induce infection,rejection,invasion and other complications.CONCLUSION：The emergence of biomaterial patch greatly avoids erosion,but the life,safety,and objective effect remain controversial.