不同材料制成尿道支架的生物相容性

Biocompatibility of urethral stent made from different materials

背景:利用各种生物材料进行泌尿系统的修复和重建,一直是重建医学研究的重点。目的:评价不同材料制成尿道支架在治疗泌尿系统疾病的临床效果、并发症和应用情况及不同置入方法对避免术后并发症所起的作用。方法:采用电子检索的方式在万方数据库中检索1990-01/2010-12有关尿道支架置入的研究,关键词为"尿道支架材料,生物相容性"。排除重复研究、普通综述或Meta分析类文章,筛选纳入19篇文献进行评价。结果与结论:目前不同材料制成的尿道支架主要有镍钛记忆合金网状支架、镍钛记忆合金螺旋支架、钛丝螺旋支架和硅胶支架等。镍钛记忆合金螺旋支架虽然具有良好的柔韧性和生物相容性,其管壁具有良好的通透性,引流确实可靠,但支架易发生倒伏或套叠,不宜长期放置。镍钛记忆合金网状支架明显优于螺旋支架,有足够大的直径和支撑力,近期疗效显著。钛丝螺旋尿道支架治疗老年下尿道梗阻临床疗效肯定,这可能与支架特殊的中央凹型构形,在尿道内不易移位和滑脱有关。多侧孔硅胶支架管有利于尿道成形的成功,减少创伤,并不影响手术效果。用于制作尿道支架的材料选择很多,置入方法各异,在实际操作中,应根据患者实际情况采取相应的措施,以达到最满意的效果。

BACKGROUND：The repair and reconstruction of urinary system are performed with various biological materials,which has been the focus of the reconstruction of medical research.OBJECTIVE：To evaluate the clinical effect,complication and application of urethral stent made from different materials in the treatment of urinary system disease and the effect of different implantation on avoidance of complications.METHODS：Researches were related to urethral stent implantation from Wanfang database（1990-01/2010-12）by computer with the Key words of＂urethral stent material,biocompatibility＂.Repetitive,common summarization or Meta-analysis were excluded,19 literatures were screened for evaluation.RESULTS AND CONCLUSION：At present,urethral stent made from different materials including Ni-Ti memory alloy mesh stent Ni-Ti memory alloy helical stent,titanium wire helical stent and silica gel stent.Although Ni-Ti memory alloy helical stent had good flexibility and compatibility,and its dissepiments had favorable permeability and indeed reliable drainage,stent prone to lodging or overlay,and should not be long placed.Ni-Ti memory alloy mesh stent was significantly better than helical stent.Ni-Ti memory alloy mesh stent had large enough diameter and bearing and had a recent significant curative effect.The clinical effect of titanium wire helical stent in treatment of lower urinary tract obstruction in elderly.This may be associated with special fovea centralis of stent and difficult to shift and slip in urethra.Silica gel supporter with multi-side holes is conductive to the success of urethroplasty,reduce trauma,and does not affect the results of operations.Urethral stent for the production has a lot of choices;the method of implantation is different.In practical operation,we should according to the actual situation of patients and take corresponding measures to achieve the most satisfactory results.