抗生素骨水泥技术在慢性创面治疗中的研究进展

Research Progress of Antibiotic Bone Cement Technology in the Treatment of Chronic Wounds

摘要: 慢性创面(如糖尿病足溃疡、压疮、骨感染创面及下肢动静脉溃疡)因发病率攀升、病理机制复杂及多重耐药菌威胁加剧，已成为临床治疗中的重大挑战。尤其以糖尿病足溃疡(Diabetic Foot Ulcer, DFU)为代表的慢性创面，因现有疗法存在疗程冗长、疗效欠佳及感染控制困难等局限，亟待创新治疗策略。近年来，含抗生素骨水泥(Antibiotic-Loaded Bone Cement, ALBC)技术因其独特优势备受关注：通过持续局部释放抗生素(如庆大霉素、万古霉素)，ALBC可有效抑制病原微生物定植，显著降低创面炎症反应；同时，其诱导膜生成特性可促进血管新生及生长因子(如TGF-β1、VEGF)表达，为组织修复创造有利微环境。大量体外实验及临床研究已证实，ALBC可缩短愈合周期、降低截肢风险，并减少耐药菌感染复发。本文系统综述ALBC技术的分子机制、临床疗效及最新研究进展，旨在为优化慢性创面治疗提供理论依据与实践参考。

Abstract: Chronic wounds (such as diabetic foot ulcers, pressure ulcers, bone infection wounds, and lower extremity arteriovenous ulcers) have become a major challenge in clinical treatment due to the increasing incidence, complex pathological mechanisms, and the aggravated threat of multidrug-resistant bacteria. In particular, chronic wounds represented by diabetic foot ulcers (DFUs), due to the limitations of existing treatment methods such as long treatment courses, poor therapeutic effects, and difficulties in infection control, urgently need innovative treatment strategies. In recent years, the technology of antibiotic-loaded bone cement (ALBC) has attracted much attention because of its unique advantages. By continuously releasing antibiotics (such as gentamicin and vancomycin) locally, ALBC can effectively inhibit the colonization of pathogenic microorganisms and significantly reduce the inflammatory response of the wound. At the same time, its property of inducing membrane formation can promote angiogenesis and the expression of growth factors (such as TGF-β1 and VEGF), creating a favorable microenvironment for tissue repair. A large number of in vitro experiments and clinical studies have confirmed that ALBC can shorten the healing cycle, reduce the risk of amputation, and decrease the recurrence of drug-resistant bacterial infections. This article systematically reviews the molecular mechanism, clinical efficacy, and the latest research progress of ALBC technology, aiming to provide a theoretical basis and practical reference for optimizing the treatment of chronic wounds.