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新型可吸收交联微孔止血粉止血效能的初步研究
赵贵成1△,巴根1△,傅强1*,李明1,倪灿荣2,汪涛3,沙菲4
0
(1.第二军医大学长海医院骨科,上海 200433
2.第二军医大学长海医院病理科,上海 200433
3.南京航空航天大学材料科学与技术学院,南京 210016
4.上海市纳米科技与产业发展促进中心,上海 200237
共同第一作者
*通信作者)
摘要:
目的 制备可吸收交联微孔止血粉,观察其对肝脏、肾脏和股动脉出血的止血效果并探讨其止血机制。方法 取成年健康新西兰兔30只,雌雄不限,体质量2 000~2 250 g,随机分成A、B、C组(A组为肝脏出血模型,B组为肾脏出血模型,C组为股动脉出血模型),每组均根据切口再随机分成可吸收交联微孔止血粉实验组(1组)和AristaTM止血粉对照组(2组),每组5只,按随机化分组原则在出血创面喷洒1 g止血材料进行止血,观察止血情况并记录出血量和止血时间。止血成功后取创伤周围组织进行H-E染色,观察组织学变化。结果 A1、A2组出血量分别为(1.02±0.10) g 和(1.03±0.09) g,止血时间分别为(92.6±5.16) s和(95.6±5.31) s,两组差异无统计学意义 (P>0.05); B1、B2组出血量分别为(0.92±0.09) g 和(0.94±0.08) g,止血时间分别为(87.5±7.48) s和(88.8±6.54) s,两组差异无统计学意义(P>0.05);C组股动脉出血模型止血失败。创伤周围组织切片H-E染色显示红细胞大量聚集,无灼伤迹象。结论 可吸收交联微孔止血粉对于实质性脏器能达到与AristaTM止血粉相似的止血效果,但不适用于压力较高的知名动脉出血的止血。
关键词:  出血  止血  止血粉  交联试剂
DOI:10.3724/SP.J.1008.2012.071
投稿时间:2011-03-18修订日期:2011-11-02
基金项目:国家自然科学基金(30872629),上海市科技启明星计划(10QH1403100).
Hemostatic function of novel absorbable crosslinked microporous hemostatic starch
ZHAO Gui-cheng1△ ,BA Gen1△ ,FU Qiang1*,LI Ming1,NI Can-rong2,WANG Tao3,SHA Fei4
(1. Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
2. Department of Pathology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
3. College of Material Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, Jiangsu, China
4. Shanghai Nanotechnology Promotion Center, Shanghai 200237, China
Co-first authors.
*Corresponding author.)
Abstract:
Objective To prepare an absorbable crosslinked microporous hemostatic starch(ACMHS), to observe its hemostasis effect in the liver, kidney and femoral artery, and to discuss the hemostasis mechanism. Methods Thirty adult healthy New Zealand rabbits of either sex, weighing 2,000-2,250 g, were equally randomized into 3 groups: liver bleeding group (group A), kidney bleeding group (group B) and femoral artery bleeding group (group C). Each group was further divided into a test group and a control group randomly (n=5) according to different hemostatic powders; ACMHS was used in the test group(group A1, B1, C1), and AristaTM was used in the control group (group A2, B2, C2). The bleeding amount and bleeding time were accurately recorded. The pathological changes at incision and in the surrounding tissues of the liver, kidney and femoral artery were observed by hematoxylin-eosin staining after test. Results All the bleeding amounts of group A1 and A2 were (1.02±0.10) g and (1.03±0.09) g, and the bleeding time periods of group A1 and A2 were (92.6±5.16) s and (95.6±5.31) s, respectively (P>0.05). All the bleeding amounts of group B1 and B2 were (0.92±0.09) g and (0.94±0.08) g, and the bleeding time periods of group B1 and B2 were (87.5±7.48) s and (88.8±6.54) s, respectively (P>0.05).All the hemostatic efforts failed in group C. Hematoxylin-eosin staining showed accumulation of red blood cells at the incision and in surrounding tissues of the liver and kidney in group A and group B, without evidence of burn. Conclusion ACMHS has the same hemostatic function as AristaTM in parenchymatous organ injury, but it is not suitable for bleeding of femoral artery injury with high pressure.
Key words:  hemorrhage  hemostasis  hemostatic powders  cross-linking reagents