组织工程骨技术治疗骨缺损的优越性

文题释义：骨缺损：是部分骨骼的缺失，小部分骨缺损机体可以自我修复，但当缺损长度超过缺损骨横径的1.5倍时，则会造成缺损处迁延不愈的情况，是临床常见病，其中四肢骨缺损最为常见。发病原因主要有高能量直接损伤和感染，以及肿瘤和骨髓炎所致也较为常见，目前对于骨缺损治疗方面有着治疗周期长，成本高，疗效不可控，并有感染、骨不连等并发症。 组织工程骨技术：是将组织工程技术应用到治疗骨缺损上，其方法是从患者自身提取出所需的种子细胞，在体外经过特殊的体外培养技术，使其大量增殖，然后把培养的种子细胞放置在适合缺陷部位形态结构的细胞支架上，接着将植入种子细胞的支架放入到已经清创的骨缺损部位，随着种子细胞的成骨作用，支架材料也开始降解，最终完成骨缺损的治疗。 背景：随着当今社会的不断发展，车祸等所造成的创伤性骨缺损越来越多见，骨缺损范围越来越大，目前骨缺损治疗有着治疗周期长、所需花费高、疗效不可控制的特点，并有感染、骨不连等并发症，给患者身心健康造成了巨大的痛苦，同时对骨科医生来说是难题也是挑战。 目的：分析传统骨缺损治疗方法的优缺点以及其最新进展，着重探究组织工程技术领域治疗骨缺损的研究进展及其优越性，作一综述。 方法：作者以“骨缺损，骨移植，组织工程，诱导膜技术，骨搬移技术，内皮祖细胞，3D打印技术”为中文关键词，以“bone defect，bone transplantation，tissue engineering，induced membrane technology，bone transfer technology，endothelial progenitor cells，3D printing technology”为英文关键词，通过检索CNKI、万方和PubMed数据库归纳总结，检索到120篇相关文献，并通过对于题目、摘要和部分文献内容的阅读，排除了时效性不强、结论模糊、重复的文献，最后纳入符合标准的49篇文献进行综述。 结果与结论：①传统骨缺损治疗方式大都存在一定的缺陷，组织工程骨技术的出现有望成为骨缺损治疗最有效的方式；②种子细胞有着良好的成骨性能并能分泌促进成骨的一些重要因子；③支架材料可为患者早期提供机械强度，有着良好生物相容性、骨诱导性、可控降解性等优势；④迫在眉睫的血管化问题也在逐步解决，能够为骨缺损患者带来福音。 ORCID: 0000-0003-3706-0771(秦宇星) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Superiority of tissue-engineered bone technology for treating bone defects

BACKGROUND:With the constant development of current society,traumatic bone injury caused by the traffic and other accidents becomes more and more common.Bone defect scope is increasingly extend,and the treatment results in the long cycle,the high cost,and the uncontrolled effect,accompanied with infections,bone nonunion and other complications,which not only causes the painfulness of the patient physically and mentally,but also is a difficult problem and challenge for orthopedic surgeons at the same time.OBJECTIVE:To analyze the advantages and disadvantages of traditional treatments and their latest progress,and focus on the research progress and advantages of tissue engineering technology in treating bone defect.METHODS: The author took “bone defect, bone transplantation, tissue engineering, induced membrane technology, bone transfer technology,endothelial progenitor cells, 3D printing technology” as the key words, and data were summarized by searching CNKI, Wanfang and PubMeddatabases. Totally 120 related literatures were retrieved. Through reading the title, abstract and part of the literature content, the outdated,ambiguous and repetitive literatures were excluded. Finally, 49 literatures meeting the inclusion criteria were selected for review.RESULTS AND CONCLUSION: (1) Traditional bone defect treatment has certain defects. The emergence of bone tissue engineeringtechnology is expected to become one of the most effective ways for bone defect. (2) Seed cells have good osteogenic properties and cansecrete some important factors. (3) Scaffold material can provide mechanical strength for patients in early stage, and has advantages of goodbiocompatibility, bone induction, and controllable degradation. (4) The urgent problem of vascularization is also being solved gradually, whichcan bring good news to the patients with bone defect.