图 1 按需取片状 SIS
图 2 采用 SIS 补片的尿道重建手术 注:A:阴茎尿道替代;B:阴茎阴囊段尿道替代 ;C:球部尿道替代;箭头所示为SIS补片。
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金扬旺,傅强. 生物再生材料修复前尿道狭窄的单中心经验[J]. 泌尿外科杂志(电子版),2023,15(1):7-11. DOI:10.20020/j.CNKI.1674-7410.2023.01.02
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尿道狭窄和尿道下裂是泌尿外科常见的疾病, 严重影响患者的生活质量,而尿道修复重建手术是 患者的首要治疗方式。目前临床上用于尿道修复重 建替代移植物主要是患者自体组织,如阴茎皮瓣、 口腔黏膜、膀胱黏膜及结肠黏膜等,但自体组织数 量有限,且以创伤修复创伤的做法会带来取材部位 的诸多并发症,因此,损伤尿道的重建修复仍然是 泌尿外科医生的一个挑战。而组织工程与再生医学 的发展为尿道修复提供了新的方向[1-2] 。上海市第六 人民医院 (以下简称上海六院) 尿道疾病诊疗技术 实力雄厚,接受尿道修复重建手术的病例数逐年上 升,到 2019 年已近 1000 例/年,位居尿道狭窄全球 单医疗中心手术量首位,尿道狭窄患者病源丰富[3] 。 近年来,上海六院探索和完善如干细胞、类器官、生物打印等组织工程新技术,为推进全层尿道功能 重建由实验室向临床应用转化贡献了宝贵经验。
1 生物再生材料修复前尿道狭窄基础研究的创新
1.1 脂肪干细胞体外向尿路上皮细胞的诱导分化
1.2 尿道修复的组织工程纳米支架材料的制备
1.3 组织工程尿道重建技术的改进与优化
2 生物再生材料修复前尿道狭窄临床应用的创新
2.1 小肠黏膜下层脱细胞基质补片重建尿道
2.2 3D 打印生物材料 (睿膜) 重建尿道
3 结语
3 结语
再生医学作为一门新兴的学科,发展至今已二 十余年,已显示了独特的优越性和良好的前景,近 年来,随着干细胞、类器官、生物打印等新技术逐 步呈现,组织工程和材料科学相结合修复脏器生理 机能重建的可靠性是以往其他技术无法可比的,但 再生材料技术在泌尿生殖领域的研究多数还集中在 实验室和动物模型上,缺乏大规模的临床应用样 本,其长期效果还有待探索。
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