应用可生物降解材料载抗生素治疗慢性骨髓炎探究进展.doc

应用可生物降解材料载抗生素治疗慢性骨髓炎探究进展 　　[摘要]慢性骨髓炎是一种由微生物所引起的骨或骨髓的感染及炎性反应状态。目前，国内外多以PMMA链珠载药体系为慢性骨髓炎的治疗方案，但术后需要二次手术将链珠取出，给患者带来不便。因此可生物降解材料在药物缓释体系中具有较大的应用前景，现阶段研究较多的聚酯类可吸收生物材料主要有3种，包括聚乳酸、聚乳酸乙醇酸交酯、聚己内酯。三种聚酯均有良好的生物可降解性及生物相容性，但聚乳酸及聚已内酯有降解缓慢的缺点。聚乳酸乙醇酸交酯降解时间与治疗骨髓炎要求的释药时间及骨缺损修复时间相仿，最为常用。聚酯可以和羟基磷灰石、磷酸三钙形成复合物，改善其自身性质，复合物比单一物质更适合于骨髓炎的治疗。本文对应用可生物降解材料负载抗生素治疗慢性骨髓炎的研究进展进行综述 [关键词]骨髓炎；可生物降解材料；聚乳酸；聚乙交酯；聚己内酯 [中图分类号] R681.2 [文献标识码] A [文章编号] 1674-4721（2016）12（a）-0015-03 Research progress on treatment for chronic osteromyelitis with absorbable biomaterials LIU Yi-xiu1，2 BAI Xi-zhuang3 A Liang2 1.Department of Sports Medicine，China Medical University，Liaoning Province，Shenyang 110001，China；2.The Second Department of Oahopedics，Affiliated Hospital of Shenyang Medical College，Liaoning Province，Shenyang 110024，China；3.Department of Sports Medicine Joint Surgery，Affiliated People′s Hospital of China Medical University，Liaoning Province，Shenyang 110016，China [Abstract]Osteomyelitis is a common inflammatory bone disease caused by pyogenic bacteria.Non-biodegradable polymethylmethacrylate （PMMA） bone cement containing antibiotics has been extensively used as a prophylaxis and for the treatment of bone infections，which needs a second surgery to remove PMMA.To date，there are three ideal kinds of absorbable biomaterials including polylactic acid，poly-ε-caprolactone，poly-（D，L-lactide-co-glycolide）.The three kinds of esters have good biodegradation and biocompatability，but the PLA and PCL take long time to degrade.PLGA takes porper time to degrade，which fulfill the antibiotic releasing and the new bone formation.The composite of esters and hydroxyapatite，β-tricalcium phosphate can greatly improve their physicochemical properties，which is better than each single biomaterial.In this paper，the progress on biodegradable materials for osteomyelitis treatment is reviewed. [Key words]Osteomyelitis；Biodegradable materials；PLA；PLGA；PCL 骨髓炎是感染性微生物引起的骨的炎?Y，是一个由于微生物感染并导致骨骼破坏的炎症反应过程，1844年Nelaton首次对其命名。