纳米抗感染硅橡胶导尿管材料的研究
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摘要
本课题旨在合成一种纳米抗感染硅橡胶导尿管材料，该材料物理热力学性能优良，具有良好的抗菌性能，并能持续20多天的抗菌效果。
采用无机蒙脱土(MMT)为原料，通过季铵盐有机改性，将具有亲水性的MMT改性成疏水性良好，并具有较大层间距的有机蒙脱土(OMMT)。同时对机械搅拌和超声波插层技术进行了初步的研究与探索，以获得具有不同层间距的有机改性钠基蒙脱土。XRD分析显示，全超声技术插层的OMMT层间距为2.51nm，而全机械插层的OMMT只有2.27nm。利用超声波技术，对钠基蒙脱土插层不同季铵盐进行有机改性。XRD分析表明，插层剂的烷基链越长，插层效果不一定越好。偏光显微镜观察可知，发现经过有机改性后，颗粒分散比较均匀。
以自备的OMMT为载体，用丁胺卡那和Bardac~(?) 2280对其进行二次插层改性。通过正交实验设计，优化实验工艺得出合成Amikacin／OMMT的最优组合为反应温度60℃，投药比例(m_(丁胺卡那)：m_(有机土))为1：4，反应时间3h，PH值为7.0；而Bardac~(?)2280／OMMT为反应温度50℃，投药比例(m_(Bardac~(?)2280)：m_(有机土))为1：1，反应时间4h，PH值为4.0。XRD分析可知，经过药物二次插层后，衍射角减小，层间距增大，Bardac~(?)2280／OMMT比Amikacin／OMMT更明显；通过偏光显微镜可以看到，经过二次插层后，粒径减小了，其中Bardac~(?)2280／OMMT比Amikacin／OMMT更显著，分散更加均匀；抑菌环实验表明，Bardac~(?)2280／OMMT对大肠杆菌、金黄色葡萄球菌和白色念珠菌均有效，且效果明显；而Amikacin／OMMT只对前两者有效。
利用插层复合法制备的纳米硅橡胶复合材料，在制备丁胺卡那—蒙脱土复合材料和Bardac~(?)2280—蒙脱土复合材料的基础上，用双辊混炼机分别制备了丁胺卡那—蒙脱土复合材料／硅橡胶片和Bardac~(?)2280—蒙脱土复合材料／硅橡胶片，并对制备的抗菌导管材料进行相关热学、力学性能和抗菌性能分析。DSC分析显示，粉体的加入，有利于硅橡胶在低温结晶，使得硅橡胶可以在更低的温度下使用；对于丁胺卡那—蒙脱土复合材料来说，7.5phr是最佳的比例，过量则使其结晶温度向高温移动；对于Bardac~(?)2280—蒙脱土复合材料来说，随着粉体含量的提高，结晶温度则一直往低温移动，但是考虑到力学性能因素，7.5phr含量较佳。力学性能测试表明，随着粉体的加入，胶料的各种力学性能增强，Bardac~(?)2280比丁胺卡那显著。偏光显微镜进行的表面分析表明：Bardac~(?)2280—蒙脱土复合材料比丁胺卡那—蒙脱土复合材料在硅橡胶载体中分散性更好，前者的相容性更好。药物缓释实验和抗菌性能实验分析表明：丁胺卡那—蒙脱土复合材料／硅橡胶具有较长的药物释放效果，但是Bardac~(?)2280—蒙脱土复合材料／硅橡胶性能更加优异，可以做理想的抗感染导尿管材料。
The aim of this paper is synthesizing a kind of nano-antiinfectionsilicon rubber catheter material, which owns the characteristic of finephysical mechanics and good antiinfection properties. What's more, suchmaterial can retain the effect of antiinfection for more than 20 days.
Montmorillonite(MMT), which possesses good hydrophilicity, wassynthesized with quaternary ammonium salt (QAS) modification intoorganic montmorillonite (OMMT), a substance being hydrophobic andlarger in layer-distance. Meanwhile, a comparing study was done onmechanic stiring method and ultrosonic technology to get differentOMMT. X-ray diffraction (XRD) showed that the layer-distance ofOMMT through whole ultrosonic technology was 2.51nm while that bymechanic stiring method was only 2.27nm. Afterwards, OMMT was madewith QASs which had different chain length, followed by the result thatthe intercalating effect was not better though the chain length of QAS waslonger. Polarizing microscope indicated that the OMMT granule dispersedbetter after modification..
A secondary intercalating modification was performed withAmikacin and Bardac(?)2280 based on OMMT to make Amikacin/MMTand Bardac(?)2280/MMT separately. The optimized synthesis technics ofcomposite materials was studied by morthogonal test. Consequently, theoptimized synthesis technics for Amikacin/MMT was as follows: reactiontemperature 60℃, ratio of casting stuff(m_(Amikacin):m_(OMMT)) 1: 4, reaction time3h, PH 7.0; while that for Bardac(?)2280/MMT is 50℃, 1: 1, 4h and 4.0correspondingly. XRD showed that diffraction angle became smaller andlayer-distance got larger for these two kinds of composite materialsespecially for Bardac(?)2280/MMT. Polarizing microscope indicated thediameters for these granules minish and disperse even better, particularly for Bardac(?)2280/MMT. Bacteriostatis effect showed thatBardac(?)2280/OMMT had a better effect.
Amikacin/OMMT rubber and Bardac(?)2280 catheters were preparedby intercalating compounding with a two-roll mixer. Afterwards, aserial of analysis was done on calorific, mechanical and antibacterialproperties. Differential scaning caloric (DSC) showed that siliconrubber could rime in a lower temperature, which made it could make intouse in such temperature; 7.5 percent was the best ratio forAmikacin/OMMT rubber and 7.5 percent for Bardac(?)2280 consideringmechanical property. The result showed that mechanical properties wereimproved as percentage of OMMT composites increased andBardac(?)2280 was more obvious than Amikacin/OMMT; meanwhile,Bardac(?)2280/OMMT dispersed better than Amikacin/OMMT inamong rubber; finally, drug releasing and antibacterial result showed thatAmikacin/OMM-rubber behaved well and Bardac(?)2280/OMMT-rubberwas much better therefore Bardac(?)2280 could be fully applied forsuch antibacterial catheters.
采用无机蒙脱土(MMT)为原料，通过季铵盐有机改性，将具有亲水性的MMT改性成疏水性良好，并具有较大层间距的有机蒙脱土(OMMT)。同时对机械搅拌和超声波插层技术进行了初步的研究与探索，以获得具有不同层间距的有机改性钠基蒙脱土。XRD分析显示，全超声技术插层的OMMT层间距为2.51nm，而全机械插层的OMMT只有2.27nm。利用超声波技术，对钠基蒙脱土插层不同季铵盐进行有机改性。XRD分析表明，插层剂的烷基链越长，插层效果不一定越好。偏光显微镜观察可知，发现经过有机改性后，颗粒分散比较均匀。
以自备的OMMT为载体，用丁胺卡那和Bardac~(?) 2280对其进行二次插层改性。通过正交实验设计，优化实验工艺得出合成Amikacin／OMMT的最优组合为反应温度60℃，投药比例(m_(丁胺卡那)：m_(有机土))为1：4，反应时间3h，PH值为7.0；而Bardac~(?)2280／OMMT为反应温度50℃，投药比例(m_(Bardac~(?)2280)：m_(有机土))为1：1，反应时间4h，PH值为4.0。XRD分析可知，经过药物二次插层后，衍射角减小，层间距增大，Bardac~(?)2280／OMMT比Amikacin／OMMT更明显；通过偏光显微镜可以看到，经过二次插层后，粒径减小了，其中Bardac~(?)2280／OMMT比Amikacin／OMMT更显著，分散更加均匀；抑菌环实验表明，Bardac~(?)2280／OMMT对大肠杆菌、金黄色葡萄球菌和白色念珠菌均有效，且效果明显；而Amikacin／OMMT只对前两者有效。
利用插层复合法制备的纳米硅橡胶复合材料，在制备丁胺卡那—蒙脱土复合材料和Bardac~(?)2280—蒙脱土复合材料的基础上，用双辊混炼机分别制备了丁胺卡那—蒙脱土复合材料／硅橡胶片和Bardac~(?)2280—蒙脱土复合材料／硅橡胶片，并对制备的抗菌导管材料进行相关热学、力学性能和抗菌性能分析。DSC分析显示，粉体的加入，有利于硅橡胶在低温结晶，使得硅橡胶可以在更低的温度下使用；对于丁胺卡那—蒙脱土复合材料来说，7.5phr是最佳的比例，过量则使其结晶温度向高温移动；对于Bardac~(?)2280—蒙脱土复合材料来说，随着粉体含量的提高，结晶温度则一直往低温移动，但是考虑到力学性能因素，7.5phr含量较佳。力学性能测试表明，随着粉体的加入，胶料的各种力学性能增强，Bardac~(?)2280比丁胺卡那显著。偏光显微镜进行的表面分析表明：Bardac~(?)2280—蒙脱土复合材料比丁胺卡那—蒙脱土复合材料在硅橡胶载体中分散性更好，前者的相容性更好。药物缓释实验和抗菌性能实验分析表明：丁胺卡那—蒙脱土复合材料／硅橡胶具有较长的药物释放效果，但是Bardac~(?)2280—蒙脱土复合材料／硅橡胶性能更加优异，可以做理想的抗感染导尿管材料。
The aim of this paper is synthesizing a kind of nano-antiinfectionsilicon rubber catheter material, which owns the characteristic of finephysical mechanics and good antiinfection properties. What's more, suchmaterial can retain the effect of antiinfection for more than 20 days.
Montmorillonite(MMT), which possesses good hydrophilicity, wassynthesized with quaternary ammonium salt (QAS) modification intoorganic montmorillonite (OMMT), a substance being hydrophobic andlarger in layer-distance. Meanwhile, a comparing study was done onmechanic stiring method and ultrosonic technology to get differentOMMT. X-ray diffraction (XRD) showed that the layer-distance ofOMMT through whole ultrosonic technology was 2.51nm while that bymechanic stiring method was only 2.27nm. Afterwards, OMMT was madewith QASs which had different chain length, followed by the result thatthe intercalating effect was not better though the chain length of QAS waslonger. Polarizing microscope indicated that the OMMT granule dispersedbetter after modification..
A secondary intercalating modification was performed withAmikacin and Bardac(?)2280 based on OMMT to make Amikacin/MMTand Bardac(?)2280/MMT separately. The optimized synthesis technics ofcomposite materials was studied by morthogonal test. Consequently, theoptimized synthesis technics for Amikacin/MMT was as follows: reactiontemperature 60℃, ratio of casting stuff(m_(Amikacin):m_(OMMT)) 1: 4, reaction time3h, PH 7.0; while that for Bardac(?)2280/MMT is 50℃, 1: 1, 4h and 4.0correspondingly. XRD showed that diffraction angle became smaller andlayer-distance got larger for these two kinds of composite materialsespecially for Bardac(?)2280/MMT. Polarizing microscope indicated thediameters for these granules minish and disperse even better, particularly for Bardac(?)2280/MMT. Bacteriostatis effect showed thatBardac(?)2280/OMMT had a better effect.
Amikacin/OMMT rubber and Bardac(?)2280 catheters were preparedby intercalating compounding with a two-roll mixer. Afterwards, aserial of analysis was done on calorific, mechanical and antibacterialproperties. Differential scaning caloric (DSC) showed that siliconrubber could rime in a lower temperature, which made it could make intouse in such temperature; 7.5 percent was the best ratio forAmikacin/OMMT rubber and 7.5 percent for Bardac(?)2280 consideringmechanical property. The result showed that mechanical properties wereimproved as percentage of OMMT composites increased andBardac(?)2280 was more obvious than Amikacin/OMMT; meanwhile,Bardac(?)2280/OMMT dispersed better than Amikacin/OMMT inamong rubber; finally, drug releasing and antibacterial result showed thatAmikacin/OMM-rubber behaved well and Bardac(?)2280/OMMT-rubberwas much better therefore Bardac(?)2280 could be fully applied forsuch antibacterial catheters.
引文
[1] 张翠萍，范丽侠，丁辉．行导尿术易发生院内感染的原因及预防护理[J]．中国误诊学杂志，2002，2(11)：1748．
[2] 赵蔚湘．美国医院感染管理概况[J]．国外医学医院管理分册，1987，4(3)：1．
[3] 中野搏．导尿引起感染及某预防管理[J]．国外医学管理分册，1989，6(2)：71-75．
[4] Gould D．导尿管引发泌尿道感染及其处置[J]．国外医学护理分册，1995，14(3)：125．
[5] Haley RW, etal. Nosocomial infections in U.S. hospitals [J]. Am J Med, 1981, 70(4): 947-959.
[6] Warren JW. The catheter and urnary tract infection[J].Mediclin North Am 1991, 25(2): 481.
[7] 陈灏珠．实用内科学[M]．北京：人民卫生出版社，1997：280．
[8] 王培华，赵敏珍．导尿术造成医院内感染的危险因素分析及评价[J]．护士进修杂志，1992，7(1)：8-9．
[9] 陈红仙．留置导尿常见问题与对策[J]．中国误诊学杂志，2003，3(6)：950-951．
[10] 杨丽君．导尿术后院内感染的原因及其预防护理措施[J]．广东医学院学报，2004，22(2)：196-197．
[11] 栗萍．12例导尿管伴随性尿路感染分析与护理[J]．国际医药卫生导报，2002，(8)：93．
[12] 许芬，李乐华．留置导尿发生菌尿症的相关因素研究[J]．护理学杂志，1997，12(2)：69．
[13] 吴阶平．泌尿外科[M]．济南：山东科学技术出版社，1993：290-291．
[14] 喻华，刘华，颜英俊，等．尿路感染病原菌分布及耐药性检测[J]．中华医院感染学杂志，2003，13(10)：982-984．
[15] 林茂虎，鲁鸿，贾宁．变形菌属引发导尿管相关尿路感染的研究[J]．中华医 院感染学杂志，2004，14(4)：468-470．
[16] 袁宏．泌尿系感染病原菌现状及体外耐药性监测[J]．中华医院感染学杂志，2005，15(1)：108 109．
[17] CostertonJW, StewartPS, GreenbergEP. Bacterial biofilms:a common cause of persistent infections[J].Science, 1999,284:1318-1322.
[18] SticklerDJ, McLeanRJC. Biomaterials associated infections:the scale of the problem[J].Cells Mater, 1995,5:167-182.
[19] Keane PF, Bonner MC, Johnston SR. Characterization of biofilm and encrustation on ureteicstents invivo[J].grit J Urol,1994,73(6):687-691.
[20] 叶海云，侯树坤，曲星珂等．细菌生物膜对尿管相关性尿路感染的影响[J]．中华泌尿外科杂志，2006，27(2)：135-138．
[21] Haswer SP, Douglas LH. Biofilm formation by candida species on the surface of cathter materials[J].Infect Immun,1994,62(3):915-921.
[22] Stickler DJ, Evans A, Morris N, etal. Strategies for the control of catheter encrustation[J].Int J Antimicrob Agents, 2002,19(6):499-506.
[23] Kumon H, Hashimoto H, Nishimura M. Catheter-associated urinary tract infections:Impact of catether materials on their manage, emg[J].HH Int J Antimicrob Agents, 2001,17(4):311-316.
[24] 付嘉环，张欣伟，梁红梅．留置导尿病人如何预防尿路感染[J]．中国社区医师，2005，7(23)：101．
[25] 陈清香，陈世伟．留置尿管常见并发症的预防及护理[J]．基层医学论坛，2005，11(7)：1338-1339．
[26] 高凤荣，赵彤等．留置导尿管引起尿路感染的原因及预防措施[J]．局解手术学杂志，2006，15(5)：353-354．
[27] Pomfret I. Catheter care-trouble shooting[J]. J Community Nurs 1999,13(6):204.
[28] Elves AWS, Feneley RCL. Long-term urethral catheterization and the urine-biomaterial interface[J]. Br J Urol 1997;80:1-5.
[29] Denstedt JD, Wollin TA, Reid G. Biomaterials used in urology: current issues of biocompatibility, infection and encrustation[J]. J Endourol 1998;12(6):493-500.
[30] Carr HA.A short history of the Foley catheter: from handmade instrument to infection-prevention device[J].J Endourol 2000,14(1):5-8.
[31] Winson L. Catheterization: a need for improved patient management[J]. Br J Nurs 1997,6:1229-1252.
[32] John Wiley. Encyclopaedia of polymer science and technology[J]. JI Kroschwitch: 2004.
[33] Synaflex: properties of common rubber elastomers, http://www.synaflex.com/elasprop.htm, 2000.
[34] Winn C. Basing catheter care on research principles[J]. Nurs Standard 1996,10:38-40.
[35] 冯圣玉等．有机硅高分子及其应用[M]．北京：工业出版社，2004，第一版：113．
[36] Saint S, Lipsky BA. Preventing catheter-related bacteriuria[J]. Arch Intern Med 1999, 159:800-808.
[37] Talia M, Ruutu M, Andersson LC, Altthan O. Urinary catheter structure and testing methods in elation to tissue toxicity[J]. Br J Urol 1986, 58:443-449.
[38] 纪莲莲．导尿及留置尿管的护理[J]．内蒙古医学杂志，2005，37(2)：187．
[39] 王丽姣．留置尿管的护理研究进展[J]．护理研究，2004，18(9A)：1519-1520．
[40] 吴大鸣，刘颖等．精密医用塑料导管的应用前景[J]．加工应用，2006．6：39-40．
[41]Rodriguez,J.L.,Trooskin, S. Z. , Greco, R. S. , Herbstman, R. A. , Donetz, A. P. and, Harvey, R. A, Reduced bacterial adherence to surfactant-coated catheters[J].Curr Surg, 1986, 43:422 - 425.
[42]Nakagawa N, Yashiro N, et al. Hydrogel-coated glide catheter: experimental studies and initial clinical experience[J]. AJR 1994, 163:1227-1229.
[43]Young C-D, Wu J-R, Tsou T-L. High-strength, ultra-thin and fiber reinforced pHEMA artificial skin[J]. Biomaterials 1998, 19:1745-52.
[44]Kamal, G. D. , Pfaller, M. A. , Rempe, L. E. , and Jebson, P. J. R. Reduced intravascular catheter infection by antibiotic bonding:A prospective, randomized, controlled trial[J].JAMA, 1991,265 (18):2346.
[45]Merrukk EW,Salzman EW,WanS, etal.The hemocompatilibility of poly etherurethaneces based on poly(ethyleneoxide)[J]. Trans AM Soc Artifintern Organs,1982,28(4):482-487.
[46]Mori Y, NagaoksS.The procedure and devalution of PEG grafted on PVC by photo induced method[J]. Trans AM Soc Artifintern Organs, 1982, 28(4) :459-463.
[47]Robert J. C. Mclean, Can. Antibacterial activity of multilayer silver copper surface films on catheter material[J]. Microbiol, 1993,39:895.
[48]JP 97 25 227.
[49]Nagaoka, S.and Akashi,R. Newly Developed Hydrophilic Slippery Surface for Medical Applications [J]. Biomaterials, 1990,11:419.
[50]Reid, G. , Lam, D. , Policova, Z. , Neumarm, A. W..Adhesion of two uro-pathogens to silicone and lubricious catheters: influence of pH, urea. and creatinine [J].Mater. Sci. , Med, 1993,4(1):17-22.
[51]Francois P,Vaudaux P,Nurdin N, etal. Physical and biological effect of a surface coating procedure on poly urethan catheters[J].Biomeaterials, 1996, 17 (7):667-678.
[52] Nurdin N, Weilandt E, Textor M, etal. Reduced frictional resistance of poly urethane catheter by means of surface coating procedure [J].Jappl Polym Sci, 1996,61(11):1939-1948.
[53] Eltonand Richad K. Lubricious hydrogel coating [P].EP 0483941 A 2,1991.
[54] Nacey JN, Tulloch AGS, Ferguson AF. Catheter-induced urethritis: a comparison between latex and silicone catheters in a prospective clinical trial[J]. Br J Urol 1985,57:325-328.
[55] Stickler DJ, Evans A, Morris N, etal. Strategies for the control of catheter encrustation[J].Int AntimicrobAgents, 2002,19(6):499-506.
[56] Schierholz JM, Yucel N, Rump AF, etal. Antiinfectice and encrustation-inhabiting materials-myth and facts[J].Int J Antimicrob Agents s,2002,19(6):511-516.
[57] Munro MS, Quattrane AJ, Ellsworth SR, etal. Surface modification of polymeric biomaterials by albumin grafting using γ-irradiation[J]. Tran. Am. Soc Artif Intern Organs, 1990,27: 499-503.
[58] Trans, Am, Soc. Artif. Intern. Organs. 36:M307-M310 1990.
[59] Trans, Am, Soc. Artif. Intern. Organs. 36:M307-M310 1990.
[60] Passerini, L.,Lam, K.,Costerton, J.W., and King, E.G.. Biofilms on indwelling vascular catheters[J].Crit Care Med, 1992,20:665.
[61] Ollock, C.A. Ibels, L.S., Caterson, R.J., Mahony, J.F., Waugh, D.A., and Cocksedge, B. Continuous ambulatory peritoneal dialysis: Eight years of experience at a single center[J].Medicine, 1989,68:293.
[62] 程定超，杨洁等．纳米银抗菌材料在医疗器具与生活用品中的应用[J]．医疗卫生装备，2004，11：29．
[63] 戴自英．实用抗菌药物学[M]．上海：上海科学技术出版社，1991．
[64] 祖庸，雷闫盈[J]．华工新型材料，1999，27(3)：14．
[65] 祖庸，雷闫盈[J]．现代化工，1999，19(8)：46．
[66] 戎红仁，赵斌，古红晨等[J]．化学世界，2000，(7)：339．
[67] 杨孝梅，伦宁，周田君等[J]．塑料加工应用，2000，22(1)：31．
[68] 高丽正彦，杉木浩子，内田理惠等[J]．防霉防微志，1994，22(9)：531．
[69] Kourai H, Manabe Y and Yamada Y.. Mode of bactericidal action of zirconium phosphate ceramics containing silver ions in the crystal structure[J]. Antiacy Antifung Agents, 1994,22:595.
[70] 陈仪本等．工业杀菌剂[M]．北京：化学工业出版社，2001：5．
[71] 李晓英．抗菌剂及抗菌材料的应用[J]．中国塑料，2001，15(2)：68．
[72] Y. Sun and G..Sun. Antimicrobial properties of modified and electrospun poly(vinyl phenol)[J]. Appl Polym Sci, 2001,80:2460.
[73] G. Sauret.,S. Dupond, K. KazmierskiandJ. Chojnowski. Polysilsesquioxan and Oligosilsesquioxanes Substituted by Alkylammonium Salts as Antibacterial Biocides[J]. Appl Polym Sci, 2000,75:1005.
[74] Kawabata, N, Nishiguchi,M. Appl Environ Microbiol, 1988,50:2532.
[75] Hazziza-Laskar, J.,Nurdin N.,Helary, G.,Sauvet, G. J Appl Polym Sci, 1993,50:651.
[76] Kawabata, N.,Hayashi, T. Improvement of aerobic treatment process by cross-linkedpolyvinylpyridine[J]. Appl Environ Microbiol, 1983,46:203.
[77] N.S. Al-Muaike.,S.S. Ali-A. Ai-Salamah, Ali. M. Zaid[J].J Appl Polym Sci, 2000,77:740.
[78] Tawfik. S.Y.,Messiha, N.N.,El-Hamouly, S.H. J Polym Sci, 1993,31:427.
[79] 李梅，王庆瑞．抗菌材料的发展及应用[J]．化工新型材料，1998，26(5)：8-11．
[80] X.F. Liu, Y.L. Guan, D.Z. Yang, Z. Li andK. D. Yao. Antibacterial action of chitosan and carboxymethylated chitosan[J].J. Appl Polym. Sci, 2001,79:1324.
[81] Fang, S.W.,Li, C.F. Antifungal activity of chitosan and its preservative effect on low-sugar candied kumquat[J].Journal of Food Protection,1994, 56:136-140.
[82]Chun,H.K,Jang, W, C, Heung. Synthesis of chitosan derivatives with quaternary ammonium salt and their antibacterial activity [J]. C. Polym Bull 1997,38:387.
[1] BalaP, SamantarayBK, SrivastavaSK. Dehadration Transformation Ca-montmorillonite[J].Bull Mater Sci,2000,23(1):61-67.
[2] 罗成刚，廖丹葵，童张法．改性膨润土在有机反应中的应用[J]．化工进展，2002，21(3)：218～220．
[3] 汤胜文．膨润土的有机改性[J]．化学世界，1996，2：71～75．
[4] 漆宗能，尚文宇．聚合物／层状硅酸盐纳米复合材料理论与实践[M]．北京：化学工业出版社，2002．9～10．
[5] JanebaD, CapkovaP, WeissZ. Molecular Mchanics studies of Montmorillonite Intercalated with Tetramethylammonium and Trimethylphenylammonium[J].J Mol Model, 1998,4:176-182.
[6] 贾卫国，张 鹏．超声化学的研究与应用[J]．辽宁大学学报，2002，29(3)：199～202．
[7] 陈建，王惠玲．声化学应用研究进展综述[J]．淮北煤师院学报，1997，18(4)：78～79．
[8] 熊大民．声化学的研究与应用现状[J]．昆明理工大学学报，2001，26(6)：84～86．
[9] 冯若．声化学基础研究中的声学问题[J]．物理学进展，1996，16(3-4)：402～405．
[10] 汪磊，周艳，贾德民．橡胶／有机蒙脱土纳米复合材料的研究[J]．弹性体，2002，12(4)：20～23．
[1] Yagisawa m., H. Yamamoto, H. Naganawa, S. Kondo, T. Takeuchi & H. Umezawa; [J].Antibiotics. 1972,25:748-750.
[2] 蒋忠良，王宇．丁胺卡那霉素的新合成方法[J]．精细与专用化学品．2004，12(10)：26-28
[3] 郭新彪，刘君桌主编．常用消毒剂和消毒方法[M]．北京：化学工业出版社．2003：121-123．
[4] 黄静，郑新安，郑新生等．有机蒙脱土对生物碱及烟碱的吸附性能研究[J]．非金属矿．2005，28(4)：8-11
[5] 杨柳燕，肖琳，周治．PH对有机蒙脱土吸附苯酚的影响[J]．环境化学．2004，23(2)：183-187
[6] GB15979-1955．产品抑菌和杀菌性能与稳定测试方法．
[7] 李博文，肖清华．载银膨润土的抗菌性能研究[J]．非金属矿．2001，24(5)：17
[8] 卫生部．消毒技术规范[M]．北京：卫生部出版社，1991
[1] 苏花平，李中华．医用高分子材料—硅橡胶[J]．化学世界，2005，3：188-189．
[2] 张承焱．硅橡胶在生物医学领域的应用[J]．有机硅材料，2002，16(6)：14-17．
[3] 夏毅然等．现代医用硅橡胶制品的性能及应用[J]．有机硅材料，2002，(3)：22-24．
[4] 刘爱堂，高桂芝．医用硅橡胶的最新进展[J]．特种橡胶制品，2003，24(2)：60-61．
[5] 蔡登科，文习山等．RTV硅橡胶／层状硅酸盐纳米绝缘的力学性能[J]．高电压技术，2003，29(11)：3-4．
[6] 武卫莉．硅橡胶的耐热性能研究[J]．合成橡胶工业，2002，25(2)：85-87．
[7] Brown MRW, Gibert P. Sensitivity of biofilm to antimicrobial agents[J].J APPl Bacteriol, 1993,74:87-97.
[2] 赵蔚湘．美国医院感染管理概况[J]．国外医学医院管理分册，1987，4(3)：1．
[3] 中野搏．导尿引起感染及某预防管理[J]．国外医学管理分册，1989，6(2)：71-75．
[4] Gould D．导尿管引发泌尿道感染及其处置[J]．国外医学护理分册，1995，14(3)：125．
[5] Haley RW, etal. Nosocomial infections in U.S. hospitals [J]. Am J Med, 1981, 70(4): 947-959.
[6] Warren JW. The catheter and urnary tract infection[J].Mediclin North Am 1991, 25(2): 481.
[7] 陈灏珠．实用内科学[M]．北京：人民卫生出版社，1997：280．
[8] 王培华，赵敏珍．导尿术造成医院内感染的危险因素分析及评价[J]．护士进修杂志，1992，7(1)：8-9．
[9] 陈红仙．留置导尿常见问题与对策[J]．中国误诊学杂志，2003，3(6)：950-951．
[10] 杨丽君．导尿术后院内感染的原因及其预防护理措施[J]．广东医学院学报，2004，22(2)：196-197．
[11] 栗萍．12例导尿管伴随性尿路感染分析与护理[J]．国际医药卫生导报，2002，(8)：93．
[12] 许芬，李乐华．留置导尿发生菌尿症的相关因素研究[J]．护理学杂志，1997，12(2)：69．
[13] 吴阶平．泌尿外科[M]．济南：山东科学技术出版社，1993：290-291．
[14] 喻华，刘华，颜英俊，等．尿路感染病原菌分布及耐药性检测[J]．中华医院感染学杂志，2003，13(10)：982-984．
[15] 林茂虎，鲁鸿，贾宁．变形菌属引发导尿管相关尿路感染的研究[J]．中华医 院感染学杂志，2004，14(4)：468-470．
[16] 袁宏．泌尿系感染病原菌现状及体外耐药性监测[J]．中华医院感染学杂志，2005，15(1)：108 109．
[17] CostertonJW, StewartPS, GreenbergEP. Bacterial biofilms:a common cause of persistent infections[J].Science, 1999,284:1318-1322.
[18] SticklerDJ, McLeanRJC. Biomaterials associated infections:the scale of the problem[J].Cells Mater, 1995,5:167-182.
[19] Keane PF, Bonner MC, Johnston SR. Characterization of biofilm and encrustation on ureteicstents invivo[J].grit J Urol,1994,73(6):687-691.
[20] 叶海云，侯树坤，曲星珂等．细菌生物膜对尿管相关性尿路感染的影响[J]．中华泌尿外科杂志，2006，27(2)：135-138．
[21] Haswer SP, Douglas LH. Biofilm formation by candida species on the surface of cathter materials[J].Infect Immun,1994,62(3):915-921.
[22] Stickler DJ, Evans A, Morris N, etal. Strategies for the control of catheter encrustation[J].Int J Antimicrob Agents, 2002,19(6):499-506.
[23] Kumon H, Hashimoto H, Nishimura M. Catheter-associated urinary tract infections:Impact of catether materials on their manage, emg[J].HH Int J Antimicrob Agents, 2001,17(4):311-316.
[24] 付嘉环，张欣伟，梁红梅．留置导尿病人如何预防尿路感染[J]．中国社区医师，2005，7(23)：101．
[25] 陈清香，陈世伟．留置尿管常见并发症的预防及护理[J]．基层医学论坛，2005，11(7)：1338-1339．
[26] 高凤荣，赵彤等．留置导尿管引起尿路感染的原因及预防措施[J]．局解手术学杂志，2006，15(5)：353-354．
[27] Pomfret I. Catheter care-trouble shooting[J]. J Community Nurs 1999,13(6):204.
[28] Elves AWS, Feneley RCL. Long-term urethral catheterization and the urine-biomaterial interface[J]. Br J Urol 1997;80:1-5.
[29] Denstedt JD, Wollin TA, Reid G. Biomaterials used in urology: current issues of biocompatibility, infection and encrustation[J]. J Endourol 1998;12(6):493-500.
[30] Carr HA.A short history of the Foley catheter: from handmade instrument to infection-prevention device[J].J Endourol 2000,14(1):5-8.
[31] Winson L. Catheterization: a need for improved patient management[J]. Br J Nurs 1997,6:1229-1252.
[32] John Wiley. Encyclopaedia of polymer science and technology[J]. JI Kroschwitch: 2004.
[33] Synaflex: properties of common rubber elastomers, http://www.synaflex.com/elasprop.htm, 2000.
[34] Winn C. Basing catheter care on research principles[J]. Nurs Standard 1996,10:38-40.
[35] 冯圣玉等．有机硅高分子及其应用[M]．北京：工业出版社，2004，第一版：113．
[36] Saint S, Lipsky BA. Preventing catheter-related bacteriuria[J]. Arch Intern Med 1999, 159:800-808.
[37] Talia M, Ruutu M, Andersson LC, Altthan O. Urinary catheter structure and testing methods in elation to tissue toxicity[J]. Br J Urol 1986, 58:443-449.
[38] 纪莲莲．导尿及留置尿管的护理[J]．内蒙古医学杂志，2005，37(2)：187．
[39] 王丽姣．留置尿管的护理研究进展[J]．护理研究，2004，18(9A)：1519-1520．
[40] 吴大鸣，刘颖等．精密医用塑料导管的应用前景[J]．加工应用，2006．6：39-40．
[41]Rodriguez,J.L.,Trooskin, S. Z. , Greco, R. S. , Herbstman, R. A. , Donetz, A. P. and, Harvey, R. A, Reduced bacterial adherence to surfactant-coated catheters[J].Curr Surg, 1986, 43:422 - 425.
[42]Nakagawa N, Yashiro N, et al. Hydrogel-coated glide catheter: experimental studies and initial clinical experience[J]. AJR 1994, 163:1227-1229.
[43]Young C-D, Wu J-R, Tsou T-L. High-strength, ultra-thin and fiber reinforced pHEMA artificial skin[J]. Biomaterials 1998, 19:1745-52.
[44]Kamal, G. D. , Pfaller, M. A. , Rempe, L. E. , and Jebson, P. J. R. Reduced intravascular catheter infection by antibiotic bonding:A prospective, randomized, controlled trial[J].JAMA, 1991,265 (18):2346.
[45]Merrukk EW,Salzman EW,WanS, etal.The hemocompatilibility of poly etherurethaneces based on poly(ethyleneoxide)[J]. Trans AM Soc Artifintern Organs,1982,28(4):482-487.
[46]Mori Y, NagaoksS.The procedure and devalution of PEG grafted on PVC by photo induced method[J]. Trans AM Soc Artifintern Organs, 1982, 28(4) :459-463.
[47]Robert J. C. Mclean, Can. Antibacterial activity of multilayer silver copper surface films on catheter material[J]. Microbiol, 1993,39:895.
[48]JP 97 25 227.
[49]Nagaoka, S.and Akashi,R. Newly Developed Hydrophilic Slippery Surface for Medical Applications [J]. Biomaterials, 1990,11:419.
[50]Reid, G. , Lam, D. , Policova, Z. , Neumarm, A. W..Adhesion of two uro-pathogens to silicone and lubricious catheters: influence of pH, urea. and creatinine [J].Mater. Sci. , Med, 1993,4(1):17-22.
[51]Francois P,Vaudaux P,Nurdin N, etal. Physical and biological effect of a surface coating procedure on poly urethan catheters[J].Biomeaterials, 1996, 17 (7):667-678.
[52] Nurdin N, Weilandt E, Textor M, etal. Reduced frictional resistance of poly urethane catheter by means of surface coating procedure [J].Jappl Polym Sci, 1996,61(11):1939-1948.
[53] Eltonand Richad K. Lubricious hydrogel coating [P].EP 0483941 A 2,1991.
[54] Nacey JN, Tulloch AGS, Ferguson AF. Catheter-induced urethritis: a comparison between latex and silicone catheters in a prospective clinical trial[J]. Br J Urol 1985,57:325-328.
[55] Stickler DJ, Evans A, Morris N, etal. Strategies for the control of catheter encrustation[J].Int AntimicrobAgents, 2002,19(6):499-506.
[56] Schierholz JM, Yucel N, Rump AF, etal. Antiinfectice and encrustation-inhabiting materials-myth and facts[J].Int J Antimicrob Agents s,2002,19(6):511-516.
[57] Munro MS, Quattrane AJ, Ellsworth SR, etal. Surface modification of polymeric biomaterials by albumin grafting using γ-irradiation[J]. Tran. Am. Soc Artif Intern Organs, 1990,27: 499-503.
[58] Trans, Am, Soc. Artif. Intern. Organs. 36:M307-M310 1990.
[59] Trans, Am, Soc. Artif. Intern. Organs. 36:M307-M310 1990.
[60] Passerini, L.,Lam, K.,Costerton, J.W., and King, E.G.. Biofilms on indwelling vascular catheters[J].Crit Care Med, 1992,20:665.
[61] Ollock, C.A. Ibels, L.S., Caterson, R.J., Mahony, J.F., Waugh, D.A., and Cocksedge, B. Continuous ambulatory peritoneal dialysis: Eight years of experience at a single center[J].Medicine, 1989,68:293.
[62] 程定超，杨洁等．纳米银抗菌材料在医疗器具与生活用品中的应用[J]．医疗卫生装备，2004，11：29．
[63] 戴自英．实用抗菌药物学[M]．上海：上海科学技术出版社，1991．
[64] 祖庸，雷闫盈[J]．华工新型材料，1999，27(3)：14．
[65] 祖庸，雷闫盈[J]．现代化工，1999，19(8)：46．
[66] 戎红仁，赵斌，古红晨等[J]．化学世界，2000，(7)：339．
[67] 杨孝梅，伦宁，周田君等[J]．塑料加工应用，2000，22(1)：31．
[68] 高丽正彦，杉木浩子，内田理惠等[J]．防霉防微志，1994，22(9)：531．
[69] Kourai H, Manabe Y and Yamada Y.. Mode of bactericidal action of zirconium phosphate ceramics containing silver ions in the crystal structure[J]. Antiacy Antifung Agents, 1994,22:595.
[70] 陈仪本等．工业杀菌剂[M]．北京：化学工业出版社，2001：5．
[71] 李晓英．抗菌剂及抗菌材料的应用[J]．中国塑料，2001，15(2)：68．
[72] Y. Sun and G..Sun. Antimicrobial properties of modified and electrospun poly(vinyl phenol)[J]. Appl Polym Sci, 2001,80:2460.
[73] G. Sauret.,S. Dupond, K. KazmierskiandJ. Chojnowski. Polysilsesquioxan and Oligosilsesquioxanes Substituted by Alkylammonium Salts as Antibacterial Biocides[J]. Appl Polym Sci, 2000,75:1005.
[74] Kawabata, N, Nishiguchi,M. Appl Environ Microbiol, 1988,50:2532.
[75] Hazziza-Laskar, J.,Nurdin N.,Helary, G.,Sauvet, G. J Appl Polym Sci, 1993,50:651.
[76] Kawabata, N.,Hayashi, T. Improvement of aerobic treatment process by cross-linkedpolyvinylpyridine[J]. Appl Environ Microbiol, 1983,46:203.
[77] N.S. Al-Muaike.,S.S. Ali-A. Ai-Salamah, Ali. M. Zaid[J].J Appl Polym Sci, 2000,77:740.
[78] Tawfik. S.Y.,Messiha, N.N.,El-Hamouly, S.H. J Polym Sci, 1993,31:427.
[79] 李梅，王庆瑞．抗菌材料的发展及应用[J]．化工新型材料，1998，26(5)：8-11．
[80] X.F. Liu, Y.L. Guan, D.Z. Yang, Z. Li andK. D. Yao. Antibacterial action of chitosan and carboxymethylated chitosan[J].J. Appl Polym. Sci, 2001,79:1324.
[81] Fang, S.W.,Li, C.F. Antifungal activity of chitosan and its preservative effect on low-sugar candied kumquat[J].Journal of Food Protection,1994, 56:136-140.
[82]Chun,H.K,Jang, W, C, Heung. Synthesis of chitosan derivatives with quaternary ammonium salt and their antibacterial activity [J]. C. Polym Bull 1997,38:387.
[1] BalaP, SamantarayBK, SrivastavaSK. Dehadration Transformation Ca-montmorillonite[J].Bull Mater Sci,2000,23(1):61-67.
[2] 罗成刚，廖丹葵，童张法．改性膨润土在有机反应中的应用[J]．化工进展，2002，21(3)：218～220．
[3] 汤胜文．膨润土的有机改性[J]．化学世界，1996，2：71～75．
[4] 漆宗能，尚文宇．聚合物／层状硅酸盐纳米复合材料理论与实践[M]．北京：化学工业出版社，2002．9～10．
[5] JanebaD, CapkovaP, WeissZ. Molecular Mchanics studies of Montmorillonite Intercalated with Tetramethylammonium and Trimethylphenylammonium[J].J Mol Model, 1998,4:176-182.
[6] 贾卫国，张 鹏．超声化学的研究与应用[J]．辽宁大学学报，2002，29(3)：199～202．
[7] 陈建，王惠玲．声化学应用研究进展综述[J]．淮北煤师院学报，1997，18(4)：78～79．
[8] 熊大民．声化学的研究与应用现状[J]．昆明理工大学学报，2001，26(6)：84～86．
[9] 冯若．声化学基础研究中的声学问题[J]．物理学进展，1996，16(3-4)：402～405．
[10] 汪磊，周艳，贾德民．橡胶／有机蒙脱土纳米复合材料的研究[J]．弹性体，2002，12(4)：20～23．
[1] Yagisawa m., H. Yamamoto, H. Naganawa, S. Kondo, T. Takeuchi & H. Umezawa; [J].Antibiotics. 1972,25:748-750.
[2] 蒋忠良，王宇．丁胺卡那霉素的新合成方法[J]．精细与专用化学品．2004，12(10)：26-28
[3] 郭新彪，刘君桌主编．常用消毒剂和消毒方法[M]．北京：化学工业出版社．2003：121-123．
[4] 黄静，郑新安，郑新生等．有机蒙脱土对生物碱及烟碱的吸附性能研究[J]．非金属矿．2005，28(4)：8-11
[5] 杨柳燕，肖琳，周治．PH对有机蒙脱土吸附苯酚的影响[J]．环境化学．2004，23(2)：183-187
[6] GB15979-1955．产品抑菌和杀菌性能与稳定测试方法．
[7] 李博文，肖清华．载银膨润土的抗菌性能研究[J]．非金属矿．2001，24(5)：17
[8] 卫生部．消毒技术规范[M]．北京：卫生部出版社，1991
[1] 苏花平，李中华．医用高分子材料—硅橡胶[J]．化学世界，2005，3：188-189．
[2] 张承焱．硅橡胶在生物医学领域的应用[J]．有机硅材料，2002，16(6)：14-17．
[3] 夏毅然等．现代医用硅橡胶制品的性能及应用[J]．有机硅材料，2002，(3)：22-24．
[4] 刘爱堂，高桂芝．医用硅橡胶的最新进展[J]．特种橡胶制品，2003，24(2)：60-61．
[5] 蔡登科，文习山等．RTV硅橡胶／层状硅酸盐纳米绝缘的力学性能[J]．高电压技术，2003，29(11)：3-4．
[6] 武卫莉．硅橡胶的耐热性能研究[J]．合成橡胶工业，2002，25(2)：85-87．
[7] Brown MRW, Gibert P. Sensitivity of biofilm to antimicrobial agents[J].J APPl Bacteriol, 1993,74:87-97.