补片在妇产科疾病中的临床应用及其生物相容性

背景：生物补片是重要的盆底组织替代物，能够替代薄弱受损的盆底筋膜组织，在盆底重建中的应用越来越广泛，但有关其疗效及生物相容性研究却少有报道。 目的：探讨生物补片在妇产科疾病中的临床应用及其生物相容性。 方法：应用计算机检索1990-01/2011-02 PubMed数据库及维普数据库有关生物补片在妇产科疾病中的临床应用及其生物相容性方面的相关文献，英文检索词“obstetrics，gynecology diseases，treatment”，中文检索词为“补片，妇产科疾病，治疗”。检索文献量总计192篇，最终纳入符合标准的文献22篇。 结果与结论：盆底修复及重建的材料作为盆底组织替代物能替代薄弱受损的盆底筋膜组织，目前大致包括生物材料、人工合成材料两类。各种修补材料均有优缺点。在各种类型植入物中，自体组织、同种异体移植物、异种移植物植入后易感染，磨损，生物相容性较差，作为重建材料并不合适。合成的可吸收补片材料坚固，应用方便，但可能发生感染、排斥和侵蚀等并发症，生物相容性较差。合成的不可吸收补片和脱细胞补片感染发生率低，并发症少，生物相容性较好。但应用哪种补片材料更佳及远期疗效等均有待于延长随访时间、大规模前瞻性病例对照研究加以验证。 关键词：重度盆腔脏器脱垂；全盆底重建；补片；生物材料；人工合成材料；综述文献 doi:10.3969/j.issn.1673-8225.2012.12.038

Clinical application and biocompatibility of patch in obstetrics and gynecology diseases

BACKGROUND: Biological patch is an important substitute of pelvic floor tissue, which can replace the impaired pelvic fascia tissue and has been widely used in pelvic floor reconstruction, but its efficacy and biocompatibility remain poorly studied. OBJECTIVE: To study the clinical application and biocompatibility of biological patch in obstetrics and gynecology disease. METHODS: An online computer-based retrieval of PubMed database and VIP database between January 1990 and December 2011 was performed for articles related to clinical application and biocompatibility of biological patch in obstetrics and gynecology disease. English key words were “obstetrics, gynecology diseases, treatment”, and Chinese key words were “patch, gynecologic and obstetric diseases, treatment”. A total of 192 literatures were screened, and 22 documents were eventually involved in the analysis. RESULTS AND CONCLUSION: Pelvic floor tissue substitutes for pelvic floor repair and reconstruction can replace the impaired pelvic fascia tissue, and can be divided into biological materials and synthetic materials. A variety of repairing materials have their advantages and disadvantages. In all types of implants, autologous tissue, allograft and xenograft are prone to infection, abrasion, poor biocompatibility after implantation, so they are not applicable as the reconstruction materials. The synthetic absorbable patch is strong, easy to use, but prone to infection, rejection and erosion, showing a poor biocompatibility. Synthetic nonabsorbable patch and acellular patch have low infection rate, few complications, and good biocompatibility. A large-size prospective case-controlled study for a longer follow-up visits are required to determine which kinds of patch materials are optimal and how is long-term efficacy results.