外科医疗器械损伤及表面处理研究进展

概述了手术器械的分类、种类及特点。重点综述了传统表面改性技术（如低温离子渗氮、离子注入技术等）对材料表面性能的影响。同时，以典型的常规手术器械，如吸引器头、止血钳为对象，从使用环境、作用机理、失效形式等方面，讨论包括腐蚀失效、断裂失效和钳类器械棘齿磨损以致夹持力失稳等几个主要机理存在的问题及表面修复的必要性。在此基础上，分别对量大面广的普通外科手术器械及高精尖的精密医疗器械进行了可修复性与使用寿命延长的讨论，具体分析了两种器械的特点、修复过程中的科学问题及国内外目前的修复办法，从而说明用低成本方式修复普通手术器械和用高可靠性手段修复精密医疗器械的要求，以及所带来的经济效益，进一步提出开展医疗器械损伤及表面处理研究的意义及重要性。

Research Progress on Injury of Surgical Instruments and Surface Treatment

The classification, types and characteristics of surgical instruments were summarized. The effects of traditional surface modification technologies, such as low-temperature ion nitriding and ion implantation, on the surface properties of materials were emphatically reviewed. Meanwhile, several typical surgical instruments, such as primer and hemostasis, were taken as the objects to discuss the problems existing in several main mechanisms, including corrosion failure, fracture failure and clamping force instability caused by ratchet wear of pliers, and the necessity of surface repair from the aspects of using circumstance, mechanism of action, failure modes, etc. Based on this, the repairability and service life extension of a large quantity and a wide range of common surgical instruments and high-precision and sophisticated medical instruments were discussed respectively. The characteristics of the two instruments, the scientific problems in the repair process and the current repair methods at home and abroad were specifically analyzed. Thus, the requirements and economic benefits of repairing common surgical instruments with low cost and precision medical instruments with high reliability were explained. The significance and importance of carrying out research on medical instrument damage and surface treatment are further proposed.