院前创伤急救止血敷料:优势与问题及应用前景  

Hemostatic dressings for prehospital trauma care:strengths,problems and prospects

作　　者：孙国飞 刘建恒[1] 张里程[1] 张立海[1] 唐佩福[1] Sun Guo-fei;Liu Jian-heng;Zhang Li-cheng;Zhang Li-hai;Tang Pei-fu(Department of Orthopaedics,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院骨科,北京市100853

出　　处：《中国组织工程研究》2018年第22期3575-3582,共8页Chinese Journal of Tissue Engineering Research

基　　金：面上项目(CWS14CO66):战创伤开放性损伤快速止血抑菌水凝胶的研发与应用研究;国家重点研发计划课题(AWS14C003):战创伤肢体软组织;骨缺损的修复研究;重大子项课题(2016YFC1102005):节段骨修复器械功能性动物实验;临床试验及临床技能研究~~

摘　　要：背景:在战场及偏远地区出现创伤性出血时,如果传统手段止血失败,使用止血敷料能够收到很好的止血效果,可作为临床上的辅助止血手段。目的:通过分析目前止血敷料的特征、成分、不良反应和止血机制,旨在探索出一种用于院前及紧急环境中的安全有效止血敷料。方法:检索PubM ed、Embase和中国知网等数据库的相关文章,英文检索主题词为"hemorrhage,wounds,injuries,hemostasis",关键词为"hemorrhage,blood loss,injuries,trauma,war,battle,hemostasis";中文检索关键词为"止血,出血,止血剂,止血敷料,创伤,院前"。结果与结论:按作用机制可将止血敷料分为浓缩凝血因子类、组织黏附剂类和补充促凝血因子类,这些止血敷料在止血效果和避免不良反应方面得到了很大改善,其中的几种止血敷料已获得了美国FDA的批准,并在战场上进行实践应用。目前尚未有理想的止血敷料,现有的止血敷料需要更多的研究来确定它们的止血效果及潜在的不良反应,发现新和更安全的止血敷料需要科研人员持续的努力。BACKGROUND： When traumatic bleeding happens in the battlefield and remote areas, hemostatic dressings as an assisted hemostasis can provide a good hemostatic effect when the traditional method is failure to stop bleeding.OBJECTIVE： To analyze the characteristics, components, side effects and hemostatic mechanism of hemostatic dressings, in order to explore a safe and effective hemostatic dressing for prehospital or emergent trauma care. METHODS： Pub Med, Embase and CNKI were retrieved using the Me SH words of ＂hemorrhage, wounds, injuries,hemostasis＂ in English and the keywords of ＂hemorrhage, blood loss, injuries, trauma, war, battle, hemostasis＂ in English and ＂hemostasis, bleeding, hemostatic agent, hemostatic dressing, wound, prehospital＂ in Chinese.RESULTS AND CONCLUSION： Hemostatic dressings are classified into concentrated coagulation factors, tissue adhesives and supplementary procoagulant factors according to the mechanism of action. These dressings have been greatly improved in the hemostatic effect and avoiding side effects, several of which have won FDA approval and applied on the battlefield. Up to now, there is still no ideal hemostatic dressing. Further investigations are required to determine the hemostatic effect and potential adverse reactions of the existing hemostatic dressings. More efforts will be made to discover new and safe hemostatic dressings.

关 键 词：生物敷料 止血 出血 血液凝固因子 组织工程 生物材料 止血敷料 凝血因子 

分 类 号：R318[医药卫生—生物医学工程]