生物补片的临床应用进展

The Progress of Biological Mesh in Clinical Application

人体组织损伤再生修复一直是临床面临的难题,近年来,随着细胞生物学和组织工程技术的发展,生物补片作为一种新兴的创伤修复材料的出现为人们带来了曙光,生物补片是天然真皮基质经脱细胞处理而形成的三维支架结构,作为生物工程支架可通过空间诱导和组织替代作用修复组织缺损,由于其去除了引起宿主免疫排斥反应的所有成分,具有良好的组织相容性,现已广泛应用于临床各领域的缺损组织修复,并取得了良好的应用前景。生物补片在疝外科的应用较为成熟,尤其对合并感染的情况治疗效果颇佳,在小儿疝外科的应用效果亦较好;在治疗肛瘘方面,生物补片的应用,改变了传统的治疗理念,实现了肛门括约肌的功能性重建;在整形医学领域中烧伤、隆鼻及隆乳方面的应用,利用生物补片再生的机制,使组织恢复原貌更具美学价值;在妇产科方面,盆底解剖及功能重建方面前景广阔。然而在骨科中的骨组织及韧带再生,泌尿外科中膀胱、输尿管及阴茎的重建,心血管邻域中修复心脏瓣膜治疗先天性心脏病方面的应用虽取得一定的成果但整体仍处于实验探索阶段,仍需继续研究拓展;生物补片虽然已形成商品化但因其价格昂贵等因素阻碍了临床广泛应用。本文就近年来生物补片在外科领域的应用研究进展作一综述。

It has become a clinical challenge to make injuried human tissue regenerated and repaired in recent years. With the development of cell biology and tissue engineering technology, the biological mesh, as the emergence of a new kind of wound dressing materials, brings the dawn. The biological mesh is formed by the natural dermal matrix acellular scaffolds structure, bio-engineering scaffolds can be induced through space and organizational alternative role in repairing tissue defects, and it is good histocompatible because all the ingredients can lead to the host immune rejection have been removed, so it is widely used in various fields of repairing clinical defect tissue and it has a good prospect. The application of biological mesh in hernia surgery is mature, especially for the cases of co-infection treatment, and achieved good results in pediatric surgical aspects. In the treatment of anal fistula, biological mesh applied to achieve a functional anal sphincter reconstruction and changed the traditional treatment philosophy. In the field of plastic surgery, like burns, nose jobs and breast implants augmentation, the biological patch has a great aesthetic value due to its ability to make tissue to restore the original appearance. In obstetrics and gynecology, it has broad prospects in pelvic floor anatomy and function reconstruction. However in the regeneration of orthopedic bone tissue and ligament, reconstruction of bladder, ureter and penis urology, and the repairment of heart valves and treatment of congenital heart diseases, the application of biological patch obtains certain results. But in terms of overall, it is still in the experimental stage of exploration, and remains to be studied further. Biological mesh has been the formation of commercialization, but expensive price and other factors restrict clinical application. In this paper, we summarized the application research of the biological mesh in the field of surgical in recent years.