KHOfl HOC - C P N G NGH6 Vfl 601 IVlPl
Tong hqii vat lieu thep khong gl 316L phil mang TIN hoac HAp, i^ng dung lam nep vit xifcJng trong y te
PGS.TS OINH THj MAI THANH, PHAM THj NAM, N G U Y I N THU PHl/aNG N G U Y I N THj THU TRANG, GS.TS THAI HOANG
W\$n Ky thu^t nhiet Ad\, V\$n Han \^m KH&CN V i l t Nam
Ngay nay, nhu cdu siir dung vat lieu y sinh, d^c biet la cac vat Ijgu y sinh cha't lirong cao ngay cang gia tdng, v i i c tim kie'm cac vat lieu mdl la rS't c3n thl@'t. Thong qua viec thu'c hien hai de tai nghl€n ci}u ma sd'VAST 04.02/11-12 va 01C-03/03-2011-2, cac nha khoa hoc thu6c VIgn Ky thuSt nhl§t m - VIgn Han lam KH&CN Vigt Nam da cho tha'y kha nang tUtfng thich sinh hpc cua hai loai vat lieu thep khong gi (TKG) 316L phu titan nitrua (TIN'/TKG316L) va TKG 316L phu hydroxyapatlt (HAp/
TKG316L) trong dung djch mg phong djch ca thg' ngifcfi trong 21 ngay thlir nghiem. Ke't qua nghign ci}u cua cac de tai vira gop phin giai quye't nhu cau ve v3t llgu y sinh, viTa gop phan giam chi phi nhap khau cac vat lieu nay.
Dat van de
Hien nay, trong phau thuat ehan thUPng va chlnh hinh cd nhieu loai vat lieu khde nhau dupc dung lam nep vit cd dinh xUdng trong qud trinh thay the vd han gdn xUdng nhU: TKG316L, hpp kim eua eoban (CoNiCrMo), titan kim loai va hdp ehat eua titan (Ti6AI4V, TiOJ. NhOng vdt lieu ndy nhin chung cd dp ben cd ly hoa va kha ndng tUdng thich sinh hpe eao vdi mdi trudng dich cd the ngUdi. Tuy nhien, trong mdt so trudng hdp cay ghep cu the, nhdng vdt lieu bang kim loai vd hpp kim vdn it nhieu b| an mdn, dan den cdc phdn dng ddo thdi Idm giam tuoi thp cua vat lieu va
gay ra nhdng khd chju nha't djnh eho benh nhan. Chfnh vi the, vdt lieu sd dyng trong qud trinh cay ghep XUdng phdi dap dng dupe cac yeu eau ed ban: cd dgc tfnh ehd'ng an mdn cao, ben cd hoe, ed su thich nghi td't vdi cd the, khdng bj bien dgng khi tiet trung d nhiet dp cao vd dd sd dung.
Tren thUc te, gid thanh eua mdt sd nep vft bang titan hoac hdp kim eua titan kha cao, do do viec dng dung vdo thuc te gap nhieu khd khan. De khac phue nhUdc diem ndy, dong thdi nang cao tinh tUdng thieh sinh hpe giijfa cdc md cua cd the ngudi vdi be mat vat lieu va dap dng cac yeu eau ed ban eua vat lieu sd dung trong ITnh vuc cay ghep xUdng, tren the
gidi da co nhieu cdng trinh nghien cdu tdng hdp mdng sinh hpe nhU titan nitrua (TiN), hydroxyapatlt (HAp) tren nen TKG vd hdp kim nham nnang lai cdc san pham y smh chat IUdng cao, phu hdp vdi nhu cau cua con ngudi [1-7]. Tuy nhien, d Viet Nam nhijfng nghien edu ve van de ndy edn han chd.
TiN la hpp chat cija titan vd nitd, CO mdu cua kim logi vdng, co dd phdn xa cao vd dien trd sud't nho, dUdc dng dung nhieu trong y sinh bdi khd ndng tUdng thich sinh hpc va chdng dn mon tdt trong mdi trudng sinh hpc. Mang TIN dUdc tong hpp bang cac phUdng phdp vdt ly nhu: ldng dpng pha hdi, phun plasma, ma xung laze, phun xg magnetron [5-7].
CdNGNCHEVIETNlSf S o i 9 nam 2013
KHOfl HQC - C 6 N G NGHe Vfl OOI MPl
H A p c d e d n g t h d c h d a hpc id Ca,Q(P0Je(0H)2, t d n tai t r o n g t d nhien d d g n g k h o a n g chat, thudc hp apatit v d Id k h o d n g ehat ehfnh t r o n g k h u n g xUdng, rang cua ngUdi v d d d n g vgt. H A p c d nhieu dng d u n g t r o n g y sinh hpc do ddc tinh quy gid c u a n d : ed hogt tfnh v d d d tUdng thfch sinh hpc cao vdi cde te b d o , ede m d , khdng bj c d t h e d a o thai, tdn tgi 6 nhieu t r a n g thdi t a p h d p . M d n g HAp m j n , m o n g , phu tren xUdng nhan tgo cd tde d y n g t a n g c u d n g kha nang lien kd't vdi cdc mo va xUdng t y n h i e n .
C d rd't nhieu phUdng phdp khac nhau dUpc s d d y n g de t o n g hdp m a n g H A p tren nen kim logi vd hdp kim nhU: phUPng p h a p vdt ly ( p l a s m a c h a n k h d n g , p h u n nhiet, phUdng p h a p p h u n xa magnetron, p h u n xa c h u m i o n , ldng d p n g pha hPi...); phUdng phdp hda hoe (sol-gel, n h d n g , ngam, ep ndng...) va phUdng phap dien hoa. M d i phUdng p h d p ddu ed Uu v d nhUdc d i e m rieng.
PhUdng phdp d i e n h o a c h o p h e p dieu khien chieu ddy m a n g v d mdng t d n g h d p dupe c d dp tinh k h i e t c a o [ 1 , 3 , 8, 9].
Vdl m y e di'ch n d n g cao ehat lupng cho cdc n e p vit b a n g kim logi v d h d p k i m , viec phu m a n g sinh hpc TiN va H A p Id rat ed trien vpng. N d u thuc hien t h d n h c d n g y tudng nay c d t h e g d p p h a n giai quyet nhu c d u s d d u n g vat lieu y sinh chat IUdng c a c n g d y c a n g tdng cua ngudi dan Viet N a m . De t h y c hien y t u d n g ndy, Vien Hdn Idm K H & C N Viet N a m va S d K H & C N H a Ndi da c a p kinh phi cho Vien Ky thudt nhiet ddi chu tri hai de tai m a so V A S T 04.02/11-12 " N g h i e n edu c h e tgo
ldp phCi to hdp y sinh titannitrit v d hydroxyapatlt c a u true nano tren nen thep khdng gi, dng d y n g lam nep vit xUdng trong y t e " v d 0 1 C - 0 3 / 0 3 - 2 0 1 1 - 2 " N g h i e n edu quy trinh t o n g h d p hydroxyapatlt ( H A p ) d a n g bpt v d m d n g , c a u true vi tinh the n h a m dng d u n g Idm vdt lieu y sinh chat IUdng eao". Hai de tdi dUdc trien khai vdi cac muc tieu c h i n h : (1) Nghien c d u quy trinh t d n g h d p m a n g H A p b d n g phUdng phdp dien h d a tren nen vat lieu T K G 3 1 6 L ; (2) LUa ehpn cae didu kien thich hpp tdng hdp m d n g T i N tren nen T K G 3 1 6 L b a n g phUdng phap phun x g m a g n e t r o n mpt c h i e u .
Cac ket qua ciiinh da dat duvc
D e dat dUdc m y c tieu c h e t a c t h a n h edng nep vft xUdng T K G 3 1 6 L phu m a n g TiN hoac HAp, hai de tai da trien khai cac ndi d u n g nghien edu ehfnh: nghien edu d n h h u d n g eua cac y e u t d d e n q u a trinh t d n g hpp m d n g HAp b a n g phUdng phdp dien hda tren ndn vgt lieu T K G 3 1 6 L ; nghien c d u cac dieu kien tdng hdp m d n g TiN tren nen T K G 3 1 6 L bang phUdng p h a p p h d n xa magnetron mpt e h i e u ; xde djnh cac dac trung h d a ly e u a hai loai vat lieu HAp/
T K G 3 1 6 L v d T i N / T K G 3 1 6 L ; khdo sat k h d n a n g tUPng thfeh sinh hpc c u n g n h u dp ben c u a hai logi vdt lieu trong d u n g dieh m o phdng dich ed the ngUdi.
M d n g H A p dUde t d n g hdp b d n g phUdng phap didn h d a tren nen T K G 3 1 6 L b a n g phUdng phap quet t h e d d n g trong d u n g djch t d n g h p p :
C a ( N 0 3 ) , 3 x 1 0 ^ M + NH^H^PO, 1,8x1 O^M + NaNOg 0 , 1 5 M + H 2 O , 6 % ; p H = 6
Nhiet dp t d n g hdp 75°C, khodng quet the 0 de'n - 1 , 6 V / SCE, 5 v d n g tUPng dng vdi thdi gian 2 6 , 6 7 phut. C d the dieu khien dUdc chieu ddy eua m a n g H A p t d n g hpp tuy t h e o t d n g m u c dich sii d u n g . Vdt lieu t d n g hdp dupe dat chi tieu chat IUdng theo tieu chuan A S T M F l 185-03.
V d t lieu H A p / T K G 3 1 6 L cd dp cdng Vickers la 1.030 kg/mm^, dp ben va d a p 50 k g . c m , d d b d m dinh 57 M P a , dp ben m d i m d n la 5 i/mil, chieu ddy m a n g k h o d n g 20 [ i m , dp g d ghe be mat trung binh, m o d u l dan hdi la 87 G P a . Tat ca cac thdng s d nay deu dap dng dUPe y e u cau Idm vdt lieu nep vit XUdng trong chinh hinh va nha khoa.
M a n g TiN dUde t o n g h p p trdn nen T K G 3 1 6 L bdng phUPng phap phun xa magnetron mot ehieu trong dieu kien: edng sud't ngudn 4 0 0 W, dp suat budng ehan khdng 0,13 Pa, nhiet do nen T K G 200°C, thdi gian m g 10-30 phdt, ty Id khf nitrP/argon 1/10 (vdi tde dp khf nitrp 4 ml/phut v d khi argon Id 40 ml/phut, hdm lUPng khf nitP 6%).
Vat lieu T i N / T K G 3 1 6 L ed dp cdng Vicker dgt 1.900 k g / m m ^ dp bdng > 100 va do ben va dap dgt theo tieu chuan A S T M B 5 7 1 - 97 (R03), dd ben ud'n 720 M P a va m o d u n ddn hdi 190 G P a .
TKG316L HAp/TKG31l
TGP cH KHOA Eac I „ S6i9nsm20i3 coNC NGHE VIET Nlftr | ^'
KHOfl HOC - C 6 N G NGHe Vfl i30l MCJI
N h u n g n g h i e n edu t h d n g h i e m vat lieu H A p / T K G 3 1 6 L v a T i N / T K G 3 1 6 L trong d u n g d j c h m d p h o n g djch e d the n g u d i c l j o thay s d hinh t h d n h m a n g H A p hay T i N vdi hinh thai hpc tUPng tU nhU tdng h d p dien h d a , ke't q u a nay da k h a n g djnh k h a n a n g tUdng thich sinh hpc c u a hai loai vdt lieu nay.
T d ede ket q u d nghien c d u d a lua c h p n d u p c d i e u kien thieh h p p de t d n g h d p vat lieu T K G 3 1 6 L phu m d n g T i N hoac m a n g H A p d a p dng y e u eau tdm n e p vit xUPng trong y t e .
Tinh sang tao
T r e n the gidi da c d mpt s d n h d m nghien cdu s d d u n g phUdng p h a p dp the hogc dp d d n g de tdng hdp m a n g H A p tren nen kim Idgi va hpp kim. Tuy n h i e n , n h d n g phUPng phdp nay cho p h e p t d n g hpp d u p c m d n g H A p cd d d bdm dfnh k h o n g cao vdi vat lieu n e n . D e khac p h y e n h u p c d i e m nay, n h d m nghien cdu da s d d y n g phUPng p h d p quet the tuyen tfnh vdi tde dp Cham de tao ra d u p c nhQng ion ehinh ( P O / " v d O H ) t h a m gia v a o p h a n dng tao H A p , do dd m d n g H A p c d dp b a m dfnh tdt vdi n e n T K G 3 1 6 L , cd d d d d n g deu v d sft chat tren be mat
Tinh urng dgng
S d n p h a m n e p vft H A p / T K G 3 1 6 L v d T i N / T K G 3 1 6 L e u a e h u n g tdi sau q u a trinh t h d n g h i e m tren d d n g vdt neu c d kd't q u d td't se dUdc tien h d n h t h d Idm s a n g tren mot so b e n h n h d n tinh n g u y e n . N e u san p h a m d u p c dUa v d o s d d y n g trong thUe te se ed khd n d n g c a n h tranh ve ehat lUPng v d gia t h a n h vdi cac s d n p h a m ngogi nhap c u n g loai d a n g c d tren thi t r u d n g Viet N a m
Hieu qua kinh te va xa hgi T r o n g tUdng lai tai Viet N a m , vat lieu H A p / T K G 3 1 6 L , T i N / T K G S i e L s e dUdc d n g d u n g v d o n g a n h p h d u t h u d t c h a n t h U d n g , c h i n h hinh v a eay g h e p x U d n g . V d i Uu d i e m e i j a m d n g p h u H A p hay T i N , n d se x u c tidn q u d trinh lien xUdng n h a n h hdn T K G 3 1 6 L k h d n g p h u H A p hay T i N , d o d d Idm g i a m thdi g i a n d i e u trj c u a b e n h n h a n ca'y g h e p . N g o a i ra, hau n h u k h d n g c d p h a n d n g d d o thai c u a c d t h e . Vdt lieu n e p vit H A p / T K G 3 1 6 L v d T i N h " K G 3 1 6 L sau khi t h d o ra khoi c d the ed the x d ly t d n g h d p lai m d n g H A p v d m a n g T i N de tdi s d d u n g e h o b e n h n h a n khde m d v a n d a p d n g tieu c h u a n eua n e p vit xUdng y te.
S a n p h a m nep vft H A p / T K G 3 1 6 L v a T i N / T K G 3 1 6 L ed y nghTa q u a n trpng ddi vdi sU phat trien kinh te - x d hpi c u a dat nUde, gdp p h a n da d a n g h d a eac san p h a m d a n g c d tren thi t r u d n g . Mat k h a c , hien nay d nudc ta p h a n Idn ede loai n e p vit b a n g kim loai t h d n g t h u d n g e u n g d a n g phdi n h d p vdi s d IUdng Idn va gia rat cao so vdi thu n h d p c u a n g u d i dan Viet N a m . D e thay the cde logi nep vft ehat IUdng cao nhdp khau, nhiem vu nghien cdu va che tao nhdng loai nep vft xUdng s d dung trong y te dUdc xdc djnh la mpt trong cac hudng Uu tien phat then tai Viet Nam •
Tai lieu tliam khao
[1) Pham Thj Nam, Nguydn The Huyen, Tran Dai Lam, Dinh Thi Mai Thanh. Nghien cifu diSn bien dien hoa cua vat lieu HAp/thep khong gl 316L trong dung dich mo phong dich cd the ngUdi. Tap chi Hoa hoc, 50(6) (2012) 699-703.
[2] Dmh Thi Mai Thanh, Pham
Thi Nam, Nguyen Thu Phuong. Le Xuan Que, Nguyen Van Anh, Thai Hoang, Tran Dai Lam. Controlling the electrodeposition, morphology and structure of hydroxyapatite coating on 316L stainless steel. Materials Science and Engineering C 33 (2013) 2037- 2045.
[3] Dong Yang Lin, Xiao - Xiang Wang, Electrodeposition of hydroxyapatite coating on CoNiCrMo- substrate in dilute solution. Surface &
coatings Technology 204, 3205-3213 (2010).
[4] Fan Xin, Chen Jian, ZOU Jian - peng, W/an Qian. Zhou Zhong - cheng, Ruan Jian-ming. Bone-ltke apatite formation on HA/316L stainless steel composite surface in simulated body fluid transactions of Nonferrous Metals Society of China Tran. Nonferrous Met.
Soc China 19 (2009) 347-352.
[5] M H Islam, R. Wuhrer, M, Berkahn, B Cornell, S.M. Valenzuela and D.K Martin. Nanostructured TiN thin films suitable for medicals application Material forum 32 (2008) 129-136
[6] Ug ur Tijrkana, Orhan OztiJrk, Ahmet E, Eroglu. Metal ion release from TiN coated CoCrMo orthopedic implant material. Surface & Coatings Technology 200 (2006) 5020-5027.
[7] B. Subramanian, CV.
Muraleedharan. R. Ananthakumar, M.
Jayachandran. A comparative study of titanium nitride (TiN). titanium oxy nitride (TiON) and titanium aluminum nitride (TIAIN), as surface coatings for bio implant.. Surface & Coatings Technology 205 (2011) 5014-5020.
[8] Wang H., Eliaz N., Xiang Z., Hsu H.P., Spector M. and Hobbs L.W. Early bone apposition in vivo on plasma-sprayed and electrochemicalfy deposited hydroxyapatite coatings on titanium alloy. Biomaterials 27 (2006) 4192-4203.
[9]. Jingdi Chen, Yingjun Wang, Xiaofeng Chen, Li Ren, Chen Lai, Wen He, Qiqing Zhang. A simple sol-gel technique for synthesis of nanostructured hydroxyapatite. tricalcium phosphate and biphasic powder. Materials Letters 65(12) (2011) 1923-1926.
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C 6 N G NGHE VIET N I W So 19 nam 2013