Cement inogona kushandiswa mumuviri wemunhu - bone simenti

Bone simenti izita rinowanzo shandiswa rebhonzo simende uye chinhu chekurapa chinoshandiswa mukurapa kwemapfupa. Nekuda kwechitarisiko chayo uye chimiro chemuviri senge simende chena inoshandiswa mukuvaka nekushongedza mushure mekusimba, ine zita rakakurumbira kudaro. Mumakore ekuma1970, simende yebhonzo yakanga yatoshandiswa kugadzirira majoini prosthesis, uye inogona kushandiswawo sekuzadza matishu uye kugadzirisa zvinhu mu orthopedics uye mazino.

Kubatsira kukuru kwesamende yebhonzo ndiko kusimba kwayo nekukurumidza, kubvumira mabasa ekutanga ekugadzirisa mushure mekuvhiyiwa. Ehe, simende yebhonzo inewo zvimwe zvipingamupinyi, senge apo neapo kukwira kwepfupa mumhango yemapfupa panguva yekuzadza, izvo zvinogona kuita kuti madonhwe emafuta apinde mutsinga uye kukonzera embolism. Uyezve, yakasiyana nemapfupa evanhu, uye nekufamba kwenguva, majoini ekugadzira angave achiri akasununguka. Naizvozvo, tsvakiridzo yebhonzo sement biomaterials yagara iri nyaya inopisa yekunetsekana nevaongorori.

Parizvino, anonyanya kushandiswa uye akatsvakurudzwa masamende emapfupa ndeye polymethyl methacrylate (PMMA) bone simenti, calcium phosphate bone simenti, uye calcium sulfate bone simenti.
PMMA bone simende is an acrylic polymer yakaumbwa nekusanganisa liquid methyl methacrylate monomer uye dynamic methyl methacrylate styrene copolymer, ine yakaderera monomer yasara, kushoma kuneta kuramba uye kusagadzikana kupaza kuramba, pamwe nekusimba kwakanyanya uye purasitiki. PMMA bone simenti yakashandiswa zvakanyanya mumunda wekuvhiyiwa kwepurasitiki yekurapa, uye yakashandiswa mukurapa mazino, dehenya, uye mamwe masango ekugadzirisa mapfupa kubva kuma1940. Acrylate bone simende yakashandiswa mukuvhiyiwa kwenyama yemunhu uye yakashandiswa mumazana ezviuru zvemakiriniki emakiriniki mukati uye kunze kwenyika.

Chikamu chakasimba chePMMA bone simende inowanzoita zvishoma polymerized prepolymer PMMA, uye chikamu chemvura iMMA monomer, ine mamwe mapolymerization ekutanga uye stabilizer akawedzerwa. Kana iyo solid-phase prepolymer PMMA yakasanganiswa neyemvura-chikamu MMA monomer, iyo polymer copolymerization reaction inoitika nekukasira kuti iwane kusimba kwebhonzo simende. Nekudaro, panguva iyi yekusimba, huwandu hukuru hwekupisa hunoburitswa, hunogona kukonzera kukuvadza kwemafuta kune akatenderedza tishu, zvichitungamira mukuzvimba uye kunyangwe tishu necrosis. Nokudaro, tsvakurudzo yakawanda inodiwa nokukurumidza kuvandudza kunaka kwepolymethyl methacrylate bone simenti uye kuderedza kana kubvisa migumisiro yePMMA bone simenti.

Calcium phosphate inoiswa mukugadzirisa mapfupa nekuda kwekunaka kwayo biocompatibility uye kugona kuvandudza bhonzo. Kliniki, inowanzoshandiswa sechinhu chinojoinwa kuzadza mapfupa emapfupa uye kugadzirisa kugadzirisa kwehardware mukuvhiya kwekutsemuka. Kuumbwa kwe calcium phosphate bone simenti yakafanana nemaminerari emapfupa evanhu, anogona kudzoserwa zvakare uye kukurudzira kukura kwemukati nekugadzirisa mapfupa echisikigo. The solidification mechanism ye calcium phosphate bone simenti ndeye dissolution hydration precipitation reaction. Nekudzora pH kukosha kwemaitiro ekuita, hydroxyapatite (HA) inogona kudonha mukati meiyo pH renji ye4.2-11. Muchikamu chekutanga, chizvarwa cheHA chinonyanya kudzorwa nekugadzirisa kwepamusoro, uye HA inogadzirwa pakati pezvikamu uye pamusoro pezvimedu zvinosimbisa kuwirirana pakati pezvikamu. Iyo yepamusoro iyo yemukati yeHA makristasi, iyo yakawanda yekusangana mapoinzi aripo, uye iyo yekumanikidza simba inowedzerawo zvinoenderana. Muchikamu chekupedzisira che hydration reaction, chikamu chepamusoro chakaputirwa nehupamhi hweHA, uye iyo hydration reaction ye calcium phosphate bone simenti inova kupararira kunodzorwa kuburikidza ne hydration reaction. Nekuenderera mberi kwe hydration reaction, yakawanda uye yakawanda HA masisitimu anogadzirwa, uye anogadzirwa HA makristasi ari kukura. Hydration zvigadzirwa zvishoma nezvishoma zvinozadza nzvimbo yemvura inotora chikamu mukuita, kuitira kuti nzvimbo yaimbogarwa nemvura inopatsanurwa kuita isina kujairika capillary pores neHA makristasi.

Iyo gel pores inowedzera, uye saizi yepore inogara yakaderedzwa. Iyo HA makristasi akazununguka uye akavharwa, uye kusimba kwekubatana pakati pezvimedu kuri kuwedzera. Iyo pfupa simende zvinhu inosimbiswa kuita yakasimba porous chimiro chine nhamba huru ye pores, nokudaro ichiratidza macro kuporesa simba.

Muchiito chekiriniki, zvinoshungurudza vertebral burst fractures zvine nzira yekukuvadza yakakosha uye inowanzoitika kune vechidiki vane simba rekuvakazve mapfupa. Calcium phosphate bone simenti inogona kushandiswa zvinobudirira kurapa kuputsika kwakadaro. Zvichakadaro, calcium phosphate bone simenti zvakare inoshanda bhonzo inotsiva benign bone bundu resection kuvhiyiwa. Nekudaro, nekuda kwekurebesa kusimba nguva uye kushoma kupisa kusunungurwa panguva yekusimba, calcium phosphate bone simenti ine hurombo hwekunamatira uye kusimba, uye inowanzo parara kubva pabhonzo. Nokudaro, tsvakurudzo ye calcium phosphate bone simenti ichiri kuenderera mberi.

Calcium sulfate ndiyo yakapusa imwe nzira yekugadzirisa mapfupa uye yakashandiswa mukugadzirisa mapfupa kweanopfuura makore zana, iine nhoroondo refu yekiriniki yekushandisa. Calcium sulfate ine kushivirira kwakanaka kwevanhu, biodegradability, uye bhonzo conduction zvivakwa, zvichiita kuti ive yakakosha imwe nzira yekuisa autologous bone mukutsvaga kwekutanga. Iyo yakasimba chikamu chikuru che calcium sulfate bone simende is anhydrous calcium sulfate poda, uye chikamu chemvura ndeye physiological saline uye mamwe aqueous mhinduro. Kana iyo yakasimba uye yemvura zvikamu zvasanganiswa, calcium sulfate inosangana ne hydration reaction, inogadzira tsono yakaumbwa nekarusiyamu sulfate dihydrate ndebvu dzinoita zambuko nekuturikidzana, zvichibva zvaoma kuita murwi neimwe chimiro uye simba. Zvisinei, nekuda kwekusagadzikana kwezvinhu zvipenyu, calcium sulfate bone simenti haigoni kuumba zvisungo zvemakemikari pakati pe calcium sulfate grafts uye bone tissue, uye ichaderedza nokukurumidza. Calcium sulfate bone simenti inogona kunyura zvachose mukati memavhiki matanhatu mushure mekusimwa, uye kukurumidza kuparara uku hakuenderane nemaitiro ekuumbwa kwemapfupa. Naizvozvo, kana zvichienzaniswa necalcium phosphate bone simenti, kukwidziridzwa uye kukiriniki yekushandiswa kwecalcium sulfate bone simende ishoma.

Mukuwedzera, zvidzidzo zvakawanda zvakaratidza kuti ma molecules maduku, biodegradable polymers, mapuroteni, polysaccharides, inorganic molecules, bioceramics, uye bioglass inogona kubudirira kuvandudza kushanda kwesamende yemapfupa, kupa mazano matsva emhando itsva dzesamende yemapfupa.
Muchidimbu, simende yebhonzo inogona kuita basa rakakosha mukiriniki yemazino uye orthopedics, uye inotarisirwa kuve yakanakisa inotakura zvinodhaka uye pfupa inotsiva zvinhu zveskeletal system.

Nekuenderera mberi kwekuvandudza uye kuvandudzwa kwesainzi, tekinoroji, uye zvinhu, zvinotendwa kuti zvimwe zvemhando yepamusoro semende zvigadzirwa zvichagadziriswa mune ramangwana, senge yakakwirira-simba, jekiseni, inodzivirira mvura, uye nekukurumidza kuseta mhando. Kushandiswa kwepfupa simenti muhutano hwekliniki huchawedzera kupararira, uye kukosha kwayo kuchawedzerawo.