骨缺损修复材料的研究现状

由肿瘤切除和创伤造成的骨缺损是日常医疗活动中常见的现象。目前,骨缺损修复的研究方向主要在骨缺损的材料上,从修复质量、免疫排斥和疾病传播等多方面来衡量,自体骨都是最佳的选择,成为骨移植的金标准。但由于供骨量有限,取骨又造成第二术区的创伤,因而它的临床应用受到了很大的限制。同种异体骨的来源比自体骨多,但与宿主间的免疫排斥反应和疾病传播是其缺点。异种骨的来源广泛,免疫原性性强、处理过程复杂和骨诱导性小是其不足之处。人工合成骨成型迅速,在计算机辅助设计和辅助制作的帮助下,能更好的合成与缺损骨形态接近的骨移植替代材料,人工合成骨的骨诱导性和仿生物性骨结构方面还不能令人满意。近年来复合骨移植和组织工程骨研究的快速发展给骨缺损修复带来了新的希望。用异体骨、异种骨或人工合成骨、金属钛网等作为支架,以富含原始骨细胞和骨生成因子的自体骨髓为填充材料修复骨缺损已取得相对满意的临床效果。组织工程骨则利用自体的原始骨细胞作为种子细胞在体外经过适当扩增,复合组织相容性好的支架材料和相关生长因子,植入体内后通过细胞分化和参与骨改建,最后形成新骨以修复骨缺损,但组织工程骨也面临着如何在骨内形成血管和神经如何支配的问题。总之,骨缺损修复材料研究的大方向为:最小的自体创伤;最大程度的仿自体骨,并不断接近自体骨的形态、结构和功能,朝着这个目标,人类的不懈努力,必将解决自身健康需要的复杂问题-修复骨缺损。

Overviews of Research on Bone Defect Restoration Material

Bone defects caused by tumor dissection or injuries is common phenomenon in daily life. The research focus of bone defect repair is on substituent materials. Auto bone graft is a golden standard because of its good repair quality, few immune rejection and low disease dissemination, but its clinical application is restricted by bone supply and trauma caused by secondary area operation. Allograft supply is abundant, but immune rejection and disease spread between allograft and host are inevitable shortages. Heterogenous bone graft has a high immunity, more complicated process and low bone inducing ability. Man-made bone graft is good at plastic shape match with the defects and costs less time, but short at bone inducing ability and bone structure bio-imitating. In recent years, the complex which compose of allograft, hetergenous bone graft or man-made bone graft, titanium net is set as scallfold, auto bone marrow which are rich in primary osteocyte and bone growth factors as component are applying in clinic practice and get a rather good results. Engineering bone graft include amplified autogenous seed osteocyte in vitro, good histo-compossiblity and relative bone growth factors, its osteogenesis to repair the defect by osteocyte differentiation and bone reconstruction after it transplanted body. How to form blood vessel and nerve dispatch are unsolved problem. In a brief, mini self trauma, max extent self bone imitating and more approach self bone in shape, structure and function are the ultimate target of bone defect restoration.