摘要
背景:随着中国人口老龄化程度日趋加重,骨质疏松性骨折发生人群的规模也逐渐增大,如何改善治疗效果,提升人民群众健康生活水平,正受到临床医生、工程师和科研人员的重视。目的:综述改善骨质疏松性骨折治疗效果的研究进展,提出治疗效果改善方案。方法:应用计算机检索万方医学网、中国知网、PubMed及Elsevier数据库收录的相关文献。中文检索词为"骨质疏松症、骨折、手术治疗、植入物、抗骨质疏松治疗、生长因子",英文检索词为"Osteoporosis,Fractures,Surgical Treatment,Implants,Anti-osteoporosis Treatment,Growth Factors"。检索文献时限为2010-2020年,最终纳入48篇文献进行综述分析。结果与结论:(1)目前,通过优化手术治疗环节和抗骨质疏松性治疗环节,均可一定程度上改善修复效果;在手术环节中利用骨挤压术,可提高短期植入物与骨折患处骨组织融合度;利用锁定钢板固定技术,可改善骨折患处骨组织的生长和恢复;手术中以自体骨、异体骨、人工骨材料和陶瓷材料等作为植入物,可充盈骨缺损部分,但仍然存在供体有限、需要二次手术、存在免疫排斥反应和生物活性不足等问题。(2)可降解聚合材料因具备良好的生物安全性、生物相容性、可塑性和可改造性,是用于骨质疏松性骨折修复的研究热点材料。(3)在骨质疏松性骨折药物治疗环节中,引入淫羊藿和二膦酸盐等药物并配合手术治疗,可取得更好的综合治疗效果。(4)研究表明,典型代表的力学敏感因子——力生长因子Ct24E对于成骨细胞的黏附、增殖、分化和矿化具有促进作用。(5)个性化设计的骨科植入物需要具备符合骨组织形成的三维空间结构,而3D打印技术可提供与患者骨折部位配备的物理结构。(6)因此,作者在综合分析了手术环节、植入物、药物和生长因子4个方面的治疗效果后认为,利用力生长因子、抗骨质�
BACKGROUND:With the increasing aging of China’s population,the number of people with osteoporotic fracture is also gradually increasing.How to improve the treatment effect and improve people’s healthy living standards is attracting the attention of clinicians,engineers and researchers.OBJECTIVE:To review the research progress of improving the treatment effect of osteoporotic fracture,and propose a improvement plan of treatment effect.METHODS:The relevant articles were searched from Wanfang Medical Database,CNKI Database,PubMed Database,and Elsevier Database by computer.The search terms were"osteoporosis,fractures,surgical treatment,implants,anti-osteoporosis treatment,growth factors"in Chinese and English.The time was limited from 2010 to 2020.Finally,48 articles were included for review.RESULTS AND CONCLUSION:(1)At present,the therapeutic effect can be improved by optimizing surgical treatment and anti-osteoporosis treatment.The surgery of bone compression can improve fusion degree between the short-term implant and fracture site bone tissue.The use of locking plate fixation technology can improve the growth and recovery of bone tissue at the fracture site.During the operation,autogenous bone,allogeneic bone,artificial bone materials,and ceramic materials were used as implants,which could fill the bone defect,but there were still some problems,such as limited donor,secondary operation,immune rejection,and insufficient biological activity.(2)Biodegradable polymeric materials,with good biosecurity,biocompatibility,plasticity,and remodelability,are hotspot in the research of osteoporotic fracture repair materials.(3)The introduction of Epimedium,bisphosphonates,and other drugs achieved better therapeutic effect than surgery alone.(4)Mechano growth factor-Ct24 E as a typical force growth factor is conducive to improving the therapeutic effect,which promotes the adhesion,proliferation,differentiation and mineralization of osteoblasts.(5)Individually designed orthopedic implants need to have a three-dimensional st
作者
彭坤
Peng Kun(Chongqing Medical and Pharmaceutical College,Chongqing 401331,China)
出处
《中国组织工程研究》
CAS
北大核心
2022年第6期980-984,共5页
Chinese Journal of Tissue Engineering Research
基金
重庆市自然科学基金(cstc2018jcyjAX0828),项目负责人:彭坤
重庆市高等学校青年骨干教师资助计划(2016),项目负责人:彭坤。
