不锈钢合金在医疗行业中的应用(yòng)

摘要：<p style="margin:0pt;"> <span style="font-family:宋體(tǐ);font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-ascii-font-family:Calibri;mso-hansi-font-family:Calibri;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;"><span style="font-family:宋體(tǐ);">不锈钢合金在医疗行业中的应用(yòng)</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">由于不锈钢合金多(duō)样化的独特性能(néng)，因而成為(wèi)了现代医學(xué)领域中不可(kě)或缺的材料。所需具备要的材料特性包括：对體(tǐ)液有(yǒu)良好的抗腐蚀性，生物(wù)相容性，优良的强重比，抗疲劳性和低磁化率。生物(wù)相容性一词较难定义，可(kě)以简单地描述為(wèi)：在人體(tǐ)的特定环境中发挥适当作用(yòng)的能(néng)力。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);">&nbsp;<span style="font-family:宋體(tǐ);">但是，传统的不锈钢材料无法达到如此严格的性能(néng)要求，例如：要达到关节植入物(wù)的耐磨性要求，通常需要使用(yòng)</span><span style="font-family:Calibri;">Co-Cr</span><span style="font-family:宋體(tǐ);">合金。在其它应用(yòng)中，由于钛合金有(yǒu)助于促进骨整合，使植入物(wù)与骨组织**附着，从而受到市场青睐。瑞典科(kē)學(xué)家</span><span style="font-family:Calibri;">Brånemark</span><span style="font-family:宋體(tǐ);">是率先采用(yòng)骨整合的先驱之一，他(tā)在</span><span style="font-family:Calibri;">60</span><span style="font-family:宋體(tǐ);">年代中期开始将含钛的牙科(kē)植入物(wù)用(yòng)于牙科(kē)医學(xué)。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">心血管支架是一种比较特殊的应用(yòng)，基于镍和钛的形状记忆合金成功地应用(yòng)于心血管支架。该领域市场庞大，应用(yòng)种类繁多(duō)，在此无法逐一描述。我们把关注点集中在其中一些应用(yòng)上。特殊合金在医疗行业中的应用(yòng)主要分(fēn)為(wèi)以下三个领域：牙科(kē)和外科(kē)器械、心血管以及康复医學(xué)。传统的不锈钢基本上用(yòng)于器械和创伤。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">牙科(kē)</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);">&nbsp;<span style="font-family:宋體(tǐ);">牙科(kē)和外科(kē)器械的种类繁多(duō)，包括铰刀(dāo)、钩子、钳子、牵开器、螺丝刀(dāo)、手术刀(dāo)片、解剖刀(dāo)和手术针。在器械应用(yòng)方面，传统不锈钢（主要是奥氏體(tǐ)不锈钢和马氏體(tǐ)不锈钢）通常能(néng)够发挥令人满意的性能(néng)。而我们在此要介绍的是沉淀硬化不锈钢</span><span style="font-family:Calibri;">Sandvik Nanoflex</span><span style="font-family:宋體(tǐ);">，其具有(yǒu)独特的性能(néng)，是严格地為(wèi)达到手术针的应用(yòng)需求而量身设计的，该应用(yòng)要求材料具备高强度和高延展性。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">沉淀物(wù)使硬化的马氏體(tǐ)基质具备更高的强度，从而实现了超过</span>3000MPa<span style="font-family:宋體(tǐ);">的拉伸强度。由于具有(yǒu)高强度、高延展性及良好的边缘保持性，该材料不仅适用(yòng)于缝合针，也可(kě)用(yòng)于钻头、螺丝刀(dāo)、龙头、铰刀(dāo)和刺血针。手术针示例参见图</span><span style="font-family:Calibri;">1a</span><span style="font-family:宋體(tǐ);">，眼科(kē)手术如图</span><span style="font-family:Calibri;">1b</span><span style="font-family:宋體(tǐ);">所示。眼睛是非常脆弱的器官，在操作时应格外小(xiǎo)心。毫无疑问，手术针必须具备高强度和高延展性才能(néng)确保手术万无一失。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">心血管</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">心血管器械的应用(yòng)包括：起搏器和</span>ICD<span style="font-family:宋體(tǐ);">（植入式心律转复除颤器）引線(xiàn)、心血管支架、导丝系统、感应線(xiàn)、人造心瓣膜、医用(yòng)导管和心血管牵开器。在一些应用(yòng)中，如：</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);">&nbsp;<span style="font-family:宋體(tǐ);">导丝和感应線(xiàn)，</span><span style="font-family:Calibri;">304</span><span style="font-family:宋體(tǐ);">型和</span><span style="font-family:Calibri;">316</span><span style="font-family:宋體(tǐ);">型奥氏體(tǐ)不锈钢能(néng)够发挥令人满意的性能(néng)。但是心血管器械通常需要采用(yòng)特殊的合金，如</span><span style="font-family:Calibri;">F562 (</span><span style="font-family:宋體(tǐ);">一种含 </span><span style="font-family:Calibri;">35% </span><span style="font-family:宋體(tǐ);">钴、</span><span style="font-family:Calibri;">35% </span><span style="font-family:宋體(tǐ);">镍</span><span style="font-family:Calibri;">, 20% </span><span style="font-family:宋體(tǐ);">铬、</span><span style="font-family:Calibri;">10% </span><span style="font-family:宋體(tǐ);">钼的合金</span><span style="font-family:Calibri;">), ASTM B684 (</span><span style="font-family:宋體(tǐ);">一种含</span><span style="font-family:Calibri;">10% </span><span style="font-family:宋體(tǐ);">或 </span><span style="font-family:Calibri;">20% </span><span style="font-family:宋體(tǐ);">铱的铂铱合金</span><span style="font-family:Calibri;">)</span><span style="font-family:宋體(tǐ);">或含贵金属芯的复合材料。由于其具有(yǒu)抗腐蚀性能(néng)、高强度和抗疲劳性能(néng)，</span><span style="font-family:Calibri;">F562</span><span style="font-family:宋體(tǐ);">也可(kě)用(yòng)于支架、起搏器和</span><span style="font-family:Calibri;">ICD</span><span style="font-family:宋體(tǐ);">引線(xiàn)。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">收缩式和扩张式外周动脉支架。形状记忆是指可(kě)以在某个温度下经受形变，然后在</span>“<span style="font-family:宋體(tǐ);">形变温度</span><span style="font-family:Calibri;">”</span><span style="font-family:宋體(tǐ);">下经加热恢复到原始无变形状态的能(néng)力。来自维基百科(kē)。</span><span style="font-family:Calibri;">&nbsp; &nbsp; &nbsp;&nbsp;</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">康复</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);">&nbsp;<span style="font-family:宋體(tǐ);">随着人口预期寿命的延長(cháng)以及世界人口数量的增長(cháng)，人體(tǐ)置换植入物(wù)的市场需求越来越大。置换植入的部位包括臀部、膝盖、肩膀、手腕和肘部。适宜的材料為(wèi)奥氏體(tǐ)不锈钢（</span><span style="font-family:Calibri;">ASTM F138, </span><span style="font-family:宋體(tǐ);">高氮</span><span style="font-family:Calibri;">ASTM F1586</span><span style="font-family:宋體(tǐ);">），钛合金（主要是</span><span style="font-family:Calibri;">Ti-6Al-4V</span><span style="font-family:宋體(tǐ);">）或钴基合金（如</span><span style="font-family:Calibri;">ASTM F75</span><span style="font-family:宋體(tǐ);">）。由于钛及其合金的弹性较软，更接近于骨头的弹性，所以不易因疲劳而失效。钢钉通常由</span><span style="font-family:Calibri;">Ti-6Al-4V</span><span style="font-family:宋體(tǐ);">制成。影响材料选择的因素是成本和患者的年龄。植入物(wù)对创伤状态起到重要的作用(yòng)，如：事故后的骨修复和骨支撑。此类植入物(wù)通常由钛或不锈钢制成。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);">X<span style="font-family:宋體(tǐ);">射線(xiàn)图像显示了膝盖完全置换（左边）和膝盖部分(fēn)置换（右边）。上部是股骨部位，下部是胫骨部位。聚合材料植入物(wù)在</span><span style="font-family:Calibri;">X</span><span style="font-family:宋體(tǐ);">射線(xiàn)图像中不可(kě)见。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">手术前膝盖植入物(wù)组件展示。它们的位置在图</span>4b<span style="font-family:宋體(tǐ);">中可(kě)见。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);">医疗器械的议题是丰富的，无法在短篇文(wén)章中**介绍。我们的目的只不过是展示出医疗领域的一些例子，来强调不锈钢合金在提高生活质量方面有(yǒu)着重要作用(yòng)。在此我们用(yòng)现实中的一个案例来进行*后的论述。</span></span> </p> <p style="margin:0pt;"> <span style="font-family:Calibri;font-size:10.5pt;mso-spacerun:&quot;yes&quot;;mso-bidi-font-family:&quot;Times New Roman&quot;;mso-font-kerning:1.0000pt;mso-fareast-font-family:宋體(tǐ);"><span style="font-family:宋體(tǐ);"><br /> </span></span> </p>