国际妇产科学杂志
國際婦產科學雜誌
국제부산과학잡지
JOURNAL OF INTERNATIONAL OBSTETRICS AND GYNECOLOGY
2015年
4期
395-400
,共6页
骨盆底%生物相容性材料%小肠%移植物
骨盆底%生物相容性材料%小腸%移植物
골분저%생물상용성재료%소장%이식물
Pelvic floor%Biocompatible materials%Small intestine,%Transplants
简述了生物材料的分类及目前常用的生物补片种类，并以猪小肠黏膜下层（small intestinal submucosa， SIS）为例，介绍了生物补片的成分及各自在组织修补过程中的作用机制。分析了同层数不同种类间或同种类不同层数间生物补片的力学强度的差异，得出目前应用较多的生物补片为4层的SIS，其力学强度既可达到支撑盆底组织早期修补的作用，又能同时兼顾阴道壁柔软度且富于弹性的特点。基于生物补片的力学性能及可降解特性，不是所有盆底重建部位都能用生物补片来进行修补，如在持续抗拉强度占主导地位部位的重建，如穹窿骶骨固定和重度膀胱膨出修补，合成网片可能会提供一个更好的解剖效果。而在治疗压力性尿失禁的手术中，两者的成功率相当。对于性生活活跃的患者，尤其是年轻女性，在恢复阴道壁的正常解剖结构及保留其柔软且富于弹性的功能方面，生物补片具有独特的优势。作为一种新兴材料，生物补片在盆底重建术中的应用尚处于探索阶段，但随着盆疷器官脱垂患者的年轻化，生物补片仍具有潜在的发展空间。
簡述瞭生物材料的分類及目前常用的生物補片種類，併以豬小腸黏膜下層（small intestinal submucosa， SIS）為例，介紹瞭生物補片的成分及各自在組織脩補過程中的作用機製。分析瞭同層數不同種類間或同種類不同層數間生物補片的力學彊度的差異，得齣目前應用較多的生物補片為4層的SIS，其力學彊度既可達到支撐盆底組織早期脩補的作用，又能同時兼顧陰道壁柔軟度且富于彈性的特點。基于生物補片的力學性能及可降解特性，不是所有盆底重建部位都能用生物補片來進行脩補，如在持續抗拉彊度佔主導地位部位的重建，如穹窿骶骨固定和重度膀胱膨齣脩補，閤成網片可能會提供一箇更好的解剖效果。而在治療壓力性尿失禁的手術中，兩者的成功率相噹。對于性生活活躍的患者，尤其是年輕女性，在恢複陰道壁的正常解剖結構及保留其柔軟且富于彈性的功能方麵，生物補片具有獨特的優勢。作為一種新興材料，生物補片在盆底重建術中的應用尚處于探索階段，但隨著盆疷器官脫垂患者的年輕化，生物補片仍具有潛在的髮展空間。
간술료생물재료적분류급목전상용적생물보편충류，병이저소장점막하층（small intestinal submucosa， SIS）위례，개소료생물보편적성분급각자재조직수보과정중적작용궤제。분석료동층수불동충류간혹동충류불동층수간생물보편적역학강도적차이，득출목전응용교다적생물보편위4층적SIS，기역학강도기가체도지탱분저조직조기수보적작용，우능동시겸고음도벽유연도차부우탄성적특점。기우생물보편적역학성능급가강해특성，불시소유분저중건부위도능용생물보편래진행수보，여재지속항랍강도점주도지위부위적중건，여궁륭저골고정화중도방광팽출수보，합성망편가능회제공일개경호적해부효과。이재치료압력성뇨실금적수술중，량자적성공솔상당。대우성생활활약적환자，우기시년경녀성，재회복음도벽적정상해부결구급보류기유연차부우탄성적공능방면，생물보편구유독특적우세。작위일충신흥재료，생물보편재분저중건술중적응용상처우탐색계단，단수착분저기관탈수환자적년경화，생물보편잉구유잠재적발전공간。
This paper resumes the classification of biological materials and common biological patch types at present. As a case study of porcine small intestinal submucosa (SIS), introduces the composition of biological patches and their role in the tissue repair process. By analyzing the mechanical strength of various biological patches, it is concluded that the SIS with four layers is current application more biological patch, it not only with the enough mechanical strength to support the early repair of the pelvic floor, but also of the characteristics of the vaginal wall flexibility and full of elasticity. Based on the mechanical properties and biodegradable properties of biological patches, not all pelvic floor reconstruction can be repaired by biological patch, such as fornix sacral fixation and severe bulging bladder, where synthetic mesh may provide a better effect of anatomy. The success rate of biological patch is equivalent to synthetic mesh in the treatment of stress urinary incontinence. However, for sexually active patients, especially young women, to restore the normal anatomy of vaginal wall and retain its soft and full of elasticity, biological patch has a unique advantage. As a new material, biological patch application in pelvic floor reconstruction is still in the stage of exploration. But with the younger of pelvic organ prolapse patients, biological patch still has a potential development space.
