【摘要】 背景：目前，3D生物打印技术凭借多尺度结构可控性与功能集成化设计能力已成为肌腱组织工程的前沿解决方案。目的：系统综述3D打印技术在肌腱修复中的最新研究进展。方法：以“3D printing,bioink,Myotendinous junction,tendon repair,Tendon-bone junction, Biomimetic scaffold”为关键词在PubMed和Web of Science数据库进行文献检索，以“3D打印，生物墨水，肌肉-肌腱界面，肌腱修复，腱骨界面，生物仿生支架”为关键词在中国知网中检索文献。排除与主题关联性不强的文章，最终纳入109篇文献进行综述。结果与结论：3D打印技术通过多材料集成和可控的仿生结构设计有效复现了肌腱的多层级结构，主流技术(如熔融电纺丝、挤出式打印等)在纤维排列、界面模拟及动态调控中发挥差异化优势，构建肌肉-肌腱界面处力学过渡层与肌腱-骨骼界面处四区渐变结构；生物墨水功能化创新(免疫调节材料、跨物种供氧支架等)及多技术协同(定向纤维沉积+光固化增强)提升支架生物活性与力学-生物学耦合能力；在愈合全周期(炎症期支撑、增殖期引导、重塑期调控)实现从分子到宏观的精准干预，优化胶原排列与修复力学性能。针对肌肉-肌腱界面处、肌腱本体、肌腱-骨骼界面处的差异化修复策略(多材料梯度、定向纤维、梯度支架)已取得进展。尽管面临分辨率-效率矛盾、材料匹配不足等挑战，3D打印技术仍为肌腱修复提供了从结构仿生到功能再生的新策略，未来智能材料(光热/压电)与多模态技术(4D打印、类器官)融合有望推动动态功能再生，为界面修复提供技术参考。更多还原

【Abstract】 BACKGROUND:Currently,three-dimensional(3D) bioprinting technology,with its controllable multi-scale structure and functional integration design capabilities,has become a cutting-edge solution for tendon tissue engineering.OBJECTIVE:To systematically summarize the latest research progress of 3D bioprinting technology in tendon repair.METHODS:Using the keywords "3D printing,bioink,myotendinous junction,tendon repair,tendon-bone junction,bionic scaffold," literature searches were conducted in the PubMed and Web of Science databases,as well as in the China National Knowledge I nfrastructure(CNKI) with the same keywords.Articles with weak relevance to the to pic were excluded,and 109 articles were ulti mately included for review.RESULTS AND CONCLUSION:3D bioprinting technology,through multi-material integration and controllable biomimetic structure design,effectively reproduces the multi-level structure of tendons.Mainstream technologies(such as melt electrospinning and extrusion printing) play differentiated advantages in fiber arrangement,interfa ce simulation,and dynamic regulation,constructing mechanical transition layers at the muscle-tendon interfa ce and four-zone gradient structures at the tendon-bone interface.Functional innovations in bioinks(such as immunomodulato ry materials and cross-species oxygen supply scaffolds) and multi-technology synergy(directional fiber deposition+photo-curing enhancement) enhance the biological activity and mechanical-biological coupling ability of the scaffolds.Throughout the entire healing cycle(suppo rt in the inflammatory phase,guidance in the prolife rative phase,and regulation in the remodeling phase),it achieves precise intervention from the molecular to the macroscopic level,optimizing collagen arrangement and repair mechanical prope rties.Differentiated repair strategies for the muscle-tendon interface,tendon body,and tendon-bone interface(such as multi-material gradients,directional fibers,and gradient scaffolds) have made progress.Des pite challenges such as the resolution-efficiency contra diction and insufficient material matching,3D printing technology still provides new strategies from structural biomimicry to functional regeneration for tendon repair.The integration of smart materials(such as photothermal/piezoelectric) and multi-modal technologies(such as 4D printing and organoids) in the future is expected to promote dynamic functional regeneration and provide technical refe rences for interface repair.更多还原