几种止血材料对兔实质脏器创伤止血性能的比较  

Hemostatic effects of several hemostatic agents on parenchymatous organ trauma in rabbits

作　　者：李东红[1] 高华[1] 李鹏熙[1] 罗菊秀[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所创伤,烧伤,复合伤国家重点实验室,重庆400042

出　　处：《创伤外科杂志》2012年第5期435-438,共4页Journal of Traumatic Surgery

基　　金：创伤;烧伤;复合伤国家重点实验室课题(SKLZZ201004)

摘　　要：目的评价明胶海绵、可吸收止血纱布、复合生物海绵和速效止血粉对兔肝、脾损伤的止血效果及周围组织反应。方法将正常状态下和肝素抗凝后的兔的肝和脾脏前端约1.0cm长的组织剪去,建立实质脏器活性出血模型,分别用不同的止血材料压敷创面,考察两种状态下创面的出血时间和出血量,取与敷料接触的肝组织进行病理分析。结果在正常状态下,明胶海绵、复合生物海绵、止血纱布和速效止血粉对肝损伤的止血时间分别为(6.28±1.45)min(、6.19±1.04)min(、5.09±1.03)min和(4.07±0.84)min,与普通纱布对照组(9.89±0.75)min相比差异有显著性意义(P<0.01);肝素抗凝后,各组的止血时间明显延长,特别是明胶海绵和止血纱布组。病理结果表明速效止血粉对肝创面组织造成热损伤。结论复合海绵和速效止血粉显示出较明胶海绵和止血纱布更好的止血效果,尤其是在肝素抗凝的情况下。但鉴于速效止血粉的热损伤和不易于清除,应限用于威胁生命的急救止血。Objective To evaluate the hemostatic effects of topical hemostatic agents： gelatin sponge,absorbable hemostatic gauze,composite sponge and quick-acting styptic powder（FlashclotTM） on parenchymatous organ trauma in rabbits,and histological changes induced by these hemostatic agents.Methods A parenchymal organ active hemorrhage model was established by transecting the livers and spleens of rabbits about 1.0 cm away from anterior extremity under the condition of normal and liquemine anticoagulation respectively.Various hemostatic materials were dressed on the wound surface separately,and the bleeding time and blood lose were accurately recorded.Tissue samples were transected from the livers contacted with dressings for histology analysis.Results Under normal condition,the hemostatic time of gelatin sponge,composite sponge,absorbable hemostatic gauze,and FlashclotTM was（6.28±1.45）minutes,（6.19±1.04）minutes,（5.09±1.03） minutes and（4.07±0.84） minutes respectively,obviously shorter than that of common gauze（9.89±0.75）minutes（P0.05）.Under the condition of liquemine anticoagulation,the hemostatic time of all groups increased obviously,especially the groups of gelatin sponge and absorbable hemostatic gauze.The result of histology analysis showed that FlashclotTM resulted in heat injury to the liver trauma area.Conclusion Both composite sponge and FlashclotTM present better hemostatic efficiency than gelatin sponge and absorbable hemostatic gauze,especially under the condition of liquemine anticoagulation.But FlashclotTM should only be applied to emergency hemostasis of life-threatening trauma due to the heat injury and difficulty in removing.

关 键 词：肝损伤 脾损伤 止血材料 兔 

分 类 号：R641[医药卫生—外科学]