骨组织工程支架及相关问题的研究

目的自体骨移植在骨外科临床应用范围广泛,存在的问题是自体供骨量严重不足,无法满足各类型较大的骨缺损.组织工程学可以实现骨的再生,为临床骨缺损的修复提供新的方法与途径.回顾近年骨组织工程学研究的进展和其近几年的研究成果,以利于骨组织工程学的深入研究.资料来源应用网络www.google.com,Medline检索近3年内中国医学核心期刊,以及1964-01/2002-12间关于骨组织工程学研究方面的相关文献,逐一校对,检索词骨组织工程学(bonetissue engneermg),支架(scaffold),羟基磷灰石复合材料(hydroxyapatie composits).资料选择选择骨组织体外培养、非晶体医用生物复合材料、骨组织工程学研究的进展、骨组织工程学研究成果的实验研究与在骨外科的临床应用等相关文献56篇.数据提炼在56篇文献中,内容呈不同程度重复的有14篇,给予删除;对42篇文献进行分类整理,用于综述,其中21篇选用为参考文献.资料综合骨组织缺损后,通常用自体骨移植的方法加以修复,移植替代物有同种异体或异体松质骨或皮质骨、关节、脱钙骨基质、骨髓,另有陶瓷及其复合移植物等;但是对长骨干的大块骨缺损、骨肿瘤大块切除或关节切除后同种、异种骨与关节的重建或修复的研究仍不很理想,尤其对骨组织与神经、肌腱、皮肤等复合组织组织工程学的研究尚处初级阶段,从骨组织工程学研究而言,骨组织工程学支架的研究已经取得明显的进展.结论组织工程学技术的研究已有重大突破,创伤后组织缺损、功能损害的有关组织工程学的研究进展最快.由于运动系统的组织结构相对简单,软骨与骨组织结构相对单一,而软骨与骨缺损在临床上又较为常见,因此,骨组织工程学在骨科领域会率先进入临床应用阶段.

Scaffold materials and related problems in bone tissue engineering

OBJECTIVE: Autologous bone transplantation has been extensively used clinically, but the scant bone source eligible for transplantation cannot meet the demand in large bone defect repair. Tissue engineering seems to provide a way out, by inducing bone regeneration for repairing bone defect. In this article, the authors review the development in bone tissue engineering achieved in recent years.DATA SOURCES: A literature review was conducted with Google and Medline-based search for reports published in Chinese on bone tissue engineering in the last 3 years, as well as for worldwide literature published from January 1964 to December 2002, using the key words for retrieval of bone tissue engineering, scaffold, hydroxyapatite composites.STUDY SELECTION: Fifty-six articles were selected, which documented in vtiro bone culture, non-crystal medical biomaterials, development of bone tissue engineering, experimental and clinical trials of bone tissue engineering and clinical application of the results of bone tissue engineering.DATA EXTRACTION:From the 56 articles, 14 were excluded for repetition of contents. The remaining 42 were classified for reviewing and 21 of these were enrolled as references here.DATA SYSTHESIS: Autologous bone grafting is the usual choice for bone defect repair. The grafts include allografts and xenograft of spongy bone and compact bone, joints, decalcified bone matrix, marrow, ceramics and ceramics composites. But the effect of repair or reconstruction of large bone defect as left by excision of large bone tumors is not satisfactory. Tissue-engineering studies on composites for repair of the damaged nerve, tendon and skin are still in their infancy, while studies of bone scaffold materials has made great progress.CONCLUSION: Great breakthroughs have been made in tissue engineering and relevant studies of tissue defect and function impairment is fast developing. As the structure of motor system and skeletal system are relatively simple,and the bone or cartilage defects clinically common, bone tissue engineering might first enter clinical use in the field of orthopedics.