骨组织工程技术治疗感染性骨缺损:优势与问题

Bone tissue engineering in infectious bone defect:advantages and problems

背景:随着现代技术及医疗水平的不断提高,用于治疗感染性骨缺损的途径虽然逐渐增多,然而困扰的难点却依然是缺少一种兼备抗感染、诱导骨折再生修复和可生物降解材料为一体的复合体,用于达到一期治疗目的措施;这也是未来医疗工作者奋进的目标和动力。目的:探讨骨组织工程技术治疗感染性骨缺损的应用及前景。方法:检索PubMed、MEDLINE、万方、中国知网、维普及中国生物医学文献数据库2013 至2019 年相关国内外文献,内容包括:①局部抗生素临床运用及研究文献;②缓释系统治疗骨感染的实验研究文献;③生物支架材料在大段骨缺损中应用的临床及实验研究文献;④骨组织工程在修复感染性骨缺损中的应用及发展文献;⑤3D 打印技术相关文献。共纳入60 篇文献分析总结。结果与结论:①骨感染部位抗生素局部使用疗效可观;②骨组织工程在诱导骨再生修复骨缺损治疗中具有远大发展前景及潜力,为未来骨科医生治疗感染性骨缺损开辟了新道路,也给患者及其家属带来新希望,而探索最合适的优质种子细胞成为该项技术的突破点及挑战;③探索骨组织工程技术、抗菌药物和可吸收性生物材料完美契合的新技术治疗感染性骨缺损,是未来骨科临床治疗感染性骨缺损的全新发展方向。

BACKGROUND: With the continuous improvement of modern technology and medical level, although there are many ways to treat infectious bone defects, there is a lack of a viable early treatment regimen that combines anti-inflammatory, fracture healing, and biodegradable therapies, for the purpose of primary treatment measures. This is also the goal and motivation of future medical workers. OBJECTIVE: To investigate the application and prospect of bone tissue engineering in the treatment of infectious bone defects. METHODS: PubMed and MEDLINE database, WanFang, CNKI, VIP and CBM database were searched from 2013 to 2019 for relevant domestic and foreign literatures, including:(1) clinical application and research literature of local antibiotics;(2) experimental study on sustained release system (DDS) for the treatment of bone infection;(3) clinical and experimental literature on biological scaffold materials in large bone defects;(4) application and progress of bone tissue engineering in the repair of infectious bone defects;(5) literature on 3D printing technology. A total of 60 literature analyses and summaries were included. RESULTS AND CONCLUSION:(1) The local use of antibiotics at bone infection site was effective.(2) Bone tissue engineering had a great development prospect and potential in inducing bone regeneration to repair bone defects, which also pointed out a new way for orthopedic surgeons to treat infectious bone defects in the future, and gave new hope to patients and their families. The breakthrough and challenge of this technology is to explore the most suitable high-quality cells.(3) To explore the perfect combination of bone tissue engineering technology, antimicrobial agents and absorbable biomaterials for the treatment of infectious bone defects with new technologies is a new development direction of the orthopedic clinical treatment for infectious bone defect in the future.