复合大孔聚多糖止血材料对小动脉离断伤的止血效果评价  

Hemostatic effect of macroporous polysaccharides composite hemostatic materials on small-artery severed injury

作　　者：许林 程刚毅 李宏伟 王洪建 林明辉 郭宏伟[3] 林链凤[3] 许零 Xu Lin;Cheng Gangyi;Li Hongwei;Wang Hongjian;Lin Minghui;Guo Hongwei;Lin Lianfeng;Xu Ling(Translational Medicine Research of Biomaterial,School of Public Health,Xiamen University,Xiamen 361102,Fujian Province,China;National Institute of Diagnostics and Vaccine Development in Infectious Disease,Xiamen University,Xiamen 361102,Fujian Province,China;First Affiliated Hospital of Xiamen University,Xiamen 361003,Fujian Province,China;Xiamen Gelfeel Biological Technology Co.,Ltd.,Xiamen 361028,Fujian Province,China)

机构地区：[1]厦门大学公共卫生学院生物基材料转化医学课题组,福建省厦门市361102 [2]国家传染病诊断试剂与疫苗工程技术研究中心,福建省厦门市361102 [3]厦门大学附属第一医院,福建省厦门市361003 [4]厦门凝赋生物科技有限公司,福建省厦门市361028

出　　处：《中国组织工程研究》2022年第34期5442-5447,共6页Chinese Journal of Tissue Engineering Research

基　　金：福建省海洋经济发展补助资金项目(FJHJF-L-2019-4),项目负责人:许零。

摘　　要：背景:当前市售可吸收止血材料对于动脉性出血的止血性能尚未达到临床理想效果。目的:研究复合大孔聚多糖止血材料在小动脉出血创伤中的止血效果。方法:通过离断兔股动脉建立小动脉出血模型,随机分为2组,实验组(n=10)采用课题组自主研发的复合大孔聚多糖止血材料,对照组(n=7)应用市售复合微孔聚多糖止血粉。术后记录两组止血成功率与出血量,动态检测血常规及肝肾功能指标检测,并通过苏木精-伊红染色观察伤口组织。结果与结论:(1)实验组的止血成功率高于对照组(90%,43%,P<0.05),两组术中出血量比较差异无显著性意义(P>0.05);(2)术后180 d内的血常规及肝肾功能指标检测结果显示,两组各指标变化趋势基本一致,并且两种止血材料均未造成明显的肝肾功能障碍,也未在降解吸收过程中发生化脓、炎症等情况;(3)术后90 d的伤口组织苏木精-红染色显示,实验组组织染色均匀,肌纤维形态结构正常、分界清晰、排列规则,间质未见明显异常,伤口处未见瘢痕等存在;对照组同样组织染色均匀,肌纤维形态结构正常、分界清晰、排列规则,间质未见明显异常,但局部出现较多瘢痕;(4)结果表明,复合大孔聚多糖止血材料的止血有效性高于市售复合微孔聚多糖止血粉,其安全性与市售复合微孔聚多糖止血粉相比非劣效,可用于体内止血。BACKGROUND:The hemostatic performance of absorbable hemostatic materials for arterial bleeding cannot meets for the clinical demands.OBJECTIVE:To study the hemostatic effect of macroporous polysaccharides composite hemostatic materials on small artery hemorrhage.METHODS:The rabbit model of arteriolar hemorrhage was established by severing the femoral artery and randomly divided into two groups.The experimental group(n=10)was treated with macroporous polysaccharides composite hemostatic materials,and the control group(n=7)was treated with commercial microporous polysaccharide hemostatic powder.After operation,hemostatic success rate,blood loss,blood routine test,liver and kidney function index were recorded and hematoxylin-eosin staining was used to observe wound tissue.RESULTS AND CONCLUSION:(1)The success ratio of hemostasis in experimental group was higher than that in the control group(90%,43%,P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).(2)The blood routine and liver and kidney function index test results within 180 days after operation showed that the change trend of each index of the two groups was basically the same,and the two hemostatic materials did not cause obvious liver and kidney dysfunction,nor did it cause purulent or inflammation in the degradation and absorption process.(3)The hematoxylin-red staining of the wound tissue 90 days after the operation showed that the tissues in the experimental group were evenly stained;the muscle fiber morphology and structure were normal;the boundaries were clear;and the arrangement was regular.There was no obvious abnormality in the interstitium,and no scars in the wound.In the control group,the tissues were uniformly stained;the morphology and structure of muscle fibers were normal;the boundaries were clear;and the arrangement was regular.There was no obvious abnormality in the interstitium,but there were more scars locally.(4)These results suggest that effectiveness of the macroporous polysaccharides c

关 键 词：复合大孔聚多糖止血材料 复合微孔聚多糖止血粉 羧甲基壳聚糖 可吸收止血材料 小动脉性止血 动脉离断 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]