中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (43): 6501-6506.doi: 10.3969/j.issn.2095-4344.2016.43.017

• 生物材料综述 biomaterial review • 上一篇    下一篇

氰基丙烯酸酯类骨黏合剂:应用在骨折骨缺损修复中的潜能和优势

黄世桥,高  辉
  

  1. 赣南医学院第一附属医院,江西省赣州市  341000
  • 收稿日期:2016-08-02 出版日期:2016-10-21 发布日期:2016-10-21
  • 通讯作者: 高辉,教授,硕士生导师,赣南医学院第一附属医院骨科,江西省赣州市 341000
  • 作者简介:黄世桥,男,1990年生,江西省赣州市人,主要从事骨组织工程和关节外科的研究。
  • 基金资助:

    江西省自然科学基金项目(20132BAB205068)

Cyanoacrylate as a bone adhesive: its potential and superiority in fracture repair

Huang Shi-qiao, Gao Hui
  

  1. First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
  • Received:2016-08-02 Online:2016-10-21 Published:2016-10-21
  • Contact: Gao Hui, Professor, Master’s supervisor, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
  • About author:Huang Shi-qiao, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
  • Supported by:
    the Natural Science Foundation of Jiangxi Province, No. 20132BAB205068

摘要:

文章快速阅读:

 

文题释义:
α-氰基丙烯酸酯
:α-氰基丙烯酸酯类结构CNCH2CCOOR中α-碳原子上结合的-CN和-COOR含有电负性极强的基团,产生诱导效应,使得β位的碳原子产生较强的吸电性,只要遇到极微量的阴离子,如-OH、-NH2等,即会瞬间发生聚合反应。由于生物体组织的基本物质是蛋白质,而蛋白质是由氨基酸组成的线性大分子化合物,大分子两端含有-NH2及-COOH基团,因此它可以迅速黏合生物体组织,它的黏合能力极强,习惯上被称为“瞬干胶”。
基丙烯酸酯类化合物作为骨黏合剂存在的问题:其一是该胶只能黏合不负重部位的小骨块,无法完成对负重部位骨的固定作用,黏度及生物力学的问题是决定骨黏合剂在骨科应用的根本属性;另一个重点问题就是胶在骨折断端的降解速度是否会对骨的生长产生阻碍作用。

背景:氰基丙烯酸酯类作为快速黏合剂被广泛应用于止血、伤口黏合、医疗栓塞等医疗领域。
目的:综述氰基丙烯酸酯类化合物的特性、对骨折治疗和改性研究的进展,指出了目前该类黏合剂应用存在的问题和今后研究的重点。
方法:应用计算机以“氰基丙烯酸酯、骨折、骨缺损”或“cyanoacrylate,fracture,bone defect”为检索词,检索CNKI和PubMed数据库2008年1月至2015年12月发表的关于氰基丙烯酸酯类化合物作为骨黏合剂的应用与对其进行改性研究的文章,最终选择40篇文章进行综述。
结果与结论:α-氰基丙烯酸酯类黏合剂已被应用于血管外科的中小管径血管吻合、血管栓塞、各类软组织修补、皮肤缝合等,其作为骨黏合剂特别是对负重部位的骨折固定尚处于动物实验阶段。其作为骨黏合剂主要存在2大方面的问题需解决:其一是只能黏合不负重部位的小骨块,无法完成对负重部位骨的固定作用,黏度及生物力学的问题是决定骨黏合剂在骨科应用的根本属性;另一个问题就是胶在骨折断端的降解速度是否会对骨的生长产生阻碍作用。通过对α-氰基丙烯酸酯类黏合剂进行改性研究,使其在在骨折、骨缺损等治疗方面表现出相对于传统内固定所不具有的潜能和优势。

关键词: 生物材料, 材料相容性, 氰基丙烯酸酯, 黏合剂, 骨折, 骨缺损, 改性研究, 纳米载药, 江西省自然科学基金

Abstract:

BACKGROUND: Cyanoacrylate adhesives are widely used in medical fields such as hemostatic agent, wound closure and medical embolism.
OBJECTIVE: To point out the problems and focus of research of cyanoacrylate adhesives used in the orthopedic field through reviewing the properties and research progress of cyanoacrylate adhesives in fracture fixation and relevant modification research.
METHODS: Articles related to cyanoacrylate as bone adhesives and relevant modification studies were retrieved in CNKI and PubMed databases (2008-01/2015-12). The key words were “cyanoacrylate, fracture, bone defect” in Chinese and English, respectively. A total of 40 articles based on inclusion and exclusion criteria were obtained for the further review.
RESULTS AND CONCLUSION: Cyanoacrylate adhesives have been widely used in medical fields such as vascular anastomosis and embolization in vascular surgery, soft tissue repair, skin closure. However, it is still in the stage of animal experiments as bone adhesives for fracture fixation in load-bearing parts. Importantly, there are two problems to be solved. First, cyanoacrylate adhesives could not complete the fixation of fracture in the load-bearing parts because of viscosity and biomechanical deficiencies. Second, it still needs to observe whether the adhesives on the fracture end hinder the growth of bone. In conclusion, modification of cyanoacrylate shows a great potential in fracture fixation compared with traditional internal fixation methods. This new method has a wonderful prospect in clinical treatment of fractures. 

Key words: Bone Cements, Fractures, Bone, Tissue Engineering

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