基于激光加工的医疗器械功能性表面研究现状

杜鑫豪; 刘志华; 张智雷; 杜策之; 隋建波; 王成勇

doi:10.13394/j.cnki.jgszz.2023.0010

基于激光加工的医疗器械功能性表面研究现状

doi: 10.13394/j.cnki.jgszz.2023.0010

广东工业大学机电工程学院, 广州510000

基金项目: 国家自然科学基金重点项目（51735003）；国家自然科学基金面上项目（52175386）；佛山市重点领域科技攻关项目（2020001006106）。

详细信息

作者简介:
杜鑫豪，男，1998年生，硕士研究生。主要研究方向：医疗器械设计与制造。E-mail：1642526409@qq.com

通讯作者:
隋建波，男，1984年生，副教授、硕士生导师。主要研究方向：医疗器械设计与制造。E-mail：jsui@gdut.edu.cn

中图分类号: TH122; R197.39; V261.8; TG665
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- 文章访问数: 293
- HTML全文浏览量: 126
- PDF下载量: 13
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-24
- 修回日期: 2023-08-05
- 录用日期: 2023-08-16
- 网络出版日期: 2023-11-06
- 刊出日期: 2024-04-01

Functional surfaces of medical devices based on laser processing: a review

College of Mechanical and Electrical Engineering, Guangdong University of Technology, Guangzhou 510000, China

摘要

摘要: 制备功能性表面是提升医疗器械治疗性能和安全性的重要方法之一。当前，基于激光加工的功能性表面微纳结构制造技术在优化医疗器械表面性能方面应用广泛。综述了医疗植入器械和手术器械表面激光加工功能性微纳结构在细胞功能调控、抗菌性、耐蚀性、摩擦特性、抗黏附性等方面的研究现状，剖析了当前医疗器械功能性表面激光加工的优势和局限，展望了医疗器械功能性表面激光加工技术的发展前景。
- 激光加工 /
- 微纳结构 /
- 功能性表面 /
- 植入器械 /
- 手术器械
Abstract: The preparation of functional surfaces is one of the important methods to enhance the therapeutic performance and safety of medical devices. Currently, the fabrication of functional surface microstructures based on laser processing is widely used in the optimizing medical device surface properties. This paper reviews the current research status of functional microstructures for laser processing of medical implantable and surgical devices in terms of cell function regulation, antimicrobial properties, corrosion resistance, frictional properties, and anti-adhesion, etc. It analyzes the advantages and limitations of laser processing of functional surfaces for medical devices and outlines the development prospects of laser processing technology for functional surfaces for medical devices.
- laser processing /
- micro and nano structures /
- functional surfaces /
- implantable devices /
- surgical instruments

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图 1 Ti6Al4V表面微纳结构的形貌及其效果

Figure 1. Shape of Ti6Al4V surface micro-nano structure and its effect

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图 2 仿生六边形结构促进细胞增殖分化

Figure 2. Bionic hexagonal structure promotes cell proliferation and differentiation

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图 3 μATZ结构促进成骨细胞增殖分化

Figure 3. μATZ structure promotes osteoblast proliferation and differentiation

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图 4 培养48 h后，金黄色葡萄球菌在结构表面的荧光显微图像和扫描电镜图

Figure 4. Fluorescence microscopic images and scanning electron microscopy of Staphylococcus aureus on the surface of the structure after 48 h incubation

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图 5 锆基非晶合金表面微纳结构对细菌黏附的影响

Figure 5. Effect of surface micro-nano structure of zirconium-based amorphous alloy on bacterial adhesion

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图 6 微槽和微蜂窝结构的细菌黏附情况

Figure 6. Bacterial adhesion in microgrooves and microcellular structures

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图 7 波纹状结构的腐蚀效果

Figure 7. Corrosion effect of corrugated structure

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图 8 骨螺钉表面微纳结构

Figure 8. Micro-nano structure of bone screw surface

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图 9 手术刀表面结构对摩擦力的影响

Figure 9. Effect of scalpel surface structure on friction

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图 10 手术刀切口对比

Figure 10. Comparison of scalpel incision

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图 11 高频电刀表面激光制备仿生鳞片结构

Figure 11. Bionic scale structure prepared by laser on the surface of high-frequency electric knife

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图 12 手术刀刀刃激光制备仿生锯齿结构

Figure 12. Laser preparation of scalpel blade with bionic serrated structure

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图 13 皮秒激光制备高频电刀的抗黏附表面

Figure 13. Anti-adhesion surface of high-frequency electric knife prepared by picosecond laser

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图 14 飞秒激光制备高频电刀的仿生抗黏附表面

Figure 14. Femtosecond laser preparation of a bionic anti-adhesive surface for high-frequency electrodes

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表 1 部分医疗植入器械和手术器械的分类与所需功能

Table 1. Classification and required functions of some medical implants and surgical instruments

分类	器械	应用	所需功能
植入器械	接骨板 + 骨螺钉	连接固定，维持骨头的位置	高耐磨性；促进骨细胞生长
	人工骨	替代人体骨协助修复骨组织缺损	具有良好的生物相容性；促进骨组织、细胞生长和黏附
	血管支架	支撑狭窄闭塞段血管，保持管腔血流通畅	表面具有良好的减阻、抗黏附作用，防止发生再狭窄
手术器械	手术刀	用于切开皮肤和肌肉	切割时形成低摩擦，减少阻力保证切口平整
	手术钳、血管夹	夹持韧致密组织、离断的组织残端	形成稳定的夹持，具有强大的湿摩擦能力防止滑脱
	高频电刀	实现对肌体组织的分离和凝固，起到切割和止血的目的	具有优秀的抗黏附性，减少因表面高温黏附的生物组织

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表 2 激光加工医疗器械功能性表面的研究现状

Table 2. Research status of laser processing of functional surfaces of medical devices

	器械类别	材料	激光参数		结构参数		主要结论	文献	性能
	器械类别	材料	波长	脉宽	形状	尺寸	主要结论	文献	性能
植入器械	骨科植入物	Ti6Al4V	—	—	微槽	宽度10，30 μm 深度10 μm	微槽表面呈亲水性，表面粗糙度增加，成骨细胞增殖和分化能力提高	[22]	细胞功能调控
	骨科植入物	Ti6Al4V	800 nm	120 fs	微坑 + 纳米波纹	微坑深度800 nm，直径30 μm 纳米波纹深度约200 nm	微坑与纳米波纹的结合提高了成骨细胞的分化能力	[23]
	牙科、骨科植入物	Ti6Al4V	1070 nm	500 μs	仿生六边形	边长150～300 μm	提高表面亲水性，能够促进成骨细胞的黏附和增殖	[24]
	骨科植入物	氧化铝增韧氧化锆陶瓷	1030 nm	560 fs	微槽 + 纳米波纹	微槽宽度10 μm 纳米波纹周期300～400 nm	细胞黏着面积、增殖数增加，表面结构可以调节细胞的排列和引导增殖	[26]
	牙科、骨科植入物	钛合金板（TA2）	1030 nm	500 fs	LIPSS、纳米柱	周期（710 ± 60）nm、（750 ± 130）nm	结构表面细菌覆盖率远小于光滑表面，抑制细菌生物膜的形成	[34]	抗菌性
	植入物	AISI 316L	1030 nm	8 ps	周期性亚微米结构	周期850 nm 深度500 nm	大肠杆菌黏附率降低了99.8%，金黄色葡萄球菌降低了70.6%	[35]
	种植体	Ti6Al4V	1064 nm	—	微坑	深度3 μm 直径20 μm	结构表面形成氧化钛结晶层，金黄色葡萄球菌的黏附率降低约85%。	[36]
植入器械	牙科、骨科植入物	Zr非晶合金	1030 nm	300 fs	LIPSS、SWPSS、微孔结构	LIPSS周期830 nm SWPSS周期 2950 nm 微孔结构周期10.24 µm、直径2.5 µm	3种结构均有抑菌效果，SWPSS最好，结构尺寸略小于细菌时，抑制效果最优	[38]
	植入物	AISI 316L	1064 nm	104 ns	微坑、微槽	深度3.7～6.2 µm	深度最大的微坑减少98%的细菌黏附，结构深度对细菌黏附行为有显著影响	[40]
	牙科种植体	3Y-TZP氧化锆陶瓷	355 nm	—	仿生蜂窝结构	边长200 µm 间距50 µm	结构表面呈现疏水性，金黄色葡萄球菌约30%	[41]
	植入物	AISI 304L	1064 nm	100 ns	波纹状	—	提高耐蚀性和抗菌性，腐蚀过后结构表面有凹坑形成	[47]	耐蚀性
	植入物	AISI 316L	355 nm	15 ns	微裂纹	—	激光改性后的表面耐蚀性提高了98.61%	[48]
	血管支架	AISI 316L	1064 nm	10 ps	LIPSS	周期220 nm	LIPSS减少了接触面积，耐腐蚀性比无结构表面提高约50倍	[50]
	骨螺钉	Ti6Al4V	1064 nm	100 ns	微凸起环、微光滑环、微重叠环	直径50 µm 深度5 µm	耐蚀性分别提高97.02%、96.11%和97.97%	[51]
手术器械	医用穿刺针	AISI 304L	532 nm	8 ps	微槽	槽宽50 µm 间距200 µm	结构能减少接触面积，减摩效果超过80%	[59]	摩擦特性
	手术刀	AISI 316L	1053 nm	12 ns	微槽	槽宽100～500 µm 槽深5～15 µm	切割时摩擦力降低33.2%，微织构表面切口更加平整	[62]
	手术刀	AISI 316L	532 nm	8 ps	微凹坑	直径110 μm 深度30 μm 间距250 μm	切割组织时摩擦力降低48%	[63]
	血管夹	Ti6Al4V	355 nm	—	微槽、微坑	直径30～54 µm 间距40～100 µm 槽宽30～50 µm	微槽宽度30 µm、间距40 µm的摩擦系数最高，摩擦力与接触面积成正比	[64]
	电刀	AISI 316L	1070 nm	500 µs	仿生鳞片	高度0.5 µm	切割过程中，摩擦系数降低约15%	[65]
	电刀	AISI 304	532 nm	10 ps	微坑、微槽	微坑直径50 µm 槽宽25～100 µm 深度12 µm	横向微槽的抗黏附效果最好，面积密度增加，黏附量减小	[72]	抗黏附性
	电刀	AISI 304	1030 nm	300 fs	仿生六边形	内接圆直径20 μm 结构间距40 μm 加工深度6 μm	仿生结构的黏附力与其疏水性呈正相关，平均组织黏附量减少约36%。	[75]
	手术刀	AISI 316L	1064 nm	100 ns	微凸圆	直径30～90 µm 间距30～90 µm	结构表面呈疏水性，对血清溶液具有强大抗黏附效果	[76]
	手术刀	AISI 316L	1064 nm	100 ns	激光烧蚀多孔	宽度4～6 μm 长度10～15 μm	结构表面可以减少血清的黏附量，其性能与疏水性呈正相关	[77]

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