氧化再生纤维素止血材料在猪肝脏出血创面模型中的止血效果  

Hemostatic effect of oxidized regenerated cellulose hemostatic material on minipig liver hemorrhage models

作　　者：霍云 孙晓青 Huo Yun;Sun Xiaoqing(Hangzhou Singclean Medical Products Co.,Ltd.,Hangzhou 310018,Zhejiang Province,China)

机构地区：[1]杭州协合医疗用品有限公司,浙江省杭州市310018

出　　处：《中国组织工程研究》2024年第10期1490-1496,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前植物来源的可吸收止血材料以进口为主,研发出非劣于同类进口产品的国产替代非常有必要。目的:观察氧化再生纤维素止血材料对猪肝出血模型的止血效果。方法:选取巴马小型猪24只,采用随机数字表法分为3组:假手术组(n=6)只做开腹手术,将伤侧肝脏取出后放回原位;实验组(n=12)建立肝脏出血创面模型后将氧化再生纤维素止血材料敷于创面上;对照组(n=6)建立肝脏出血模型后将市售可吸收止血纱敷于创面上,记录止血时间和出血量。造模前及造模后不同时间点取猪前腔静脉血,进行血常规、肝肾功能分析;造模后2,6,14周,进行创面组织苏木精-伊红与Masson染色;造模后14周,进行主要脏器病理组织学观察;造模后不同时间点进行肝脏超声检查,观察材料降解吸收情况。结果与结论:①实验组与对照组猪肝脏创面止血时间与出血量比较差异均无显著性意义(P>0.05);②血液生化指标监测结果显示,3组猪造模后24 h的谷草转氨酶和谷丙转氨酶水平均高于造模前,造模后72 h这些指标基本恢复到造模前正常水平,3组间肝肾功能、血糖及炎症因子等血液生化指标值比较差异均无显著性意义(P>0.05);③创面组织苏木精-伊红与Masson染色显示,造模后2周时,两组肝脏创面可见肉芽组织形成及大量的胶原纤维沉积,有明显的纤维增生带和炎症细胞浸润,创面愈合良好;造模后14周,两组猪肝脏创面有轻度的纤维增生带、胶原纤维沉积和少量炎症细胞浸润,材料降解完全,创面愈合;苏木精-伊红染色显示主要脏器无明显的病理组织变化;④超声检查显示,随着植入时间的延长,两组材料逐渐降解,至造模后56 d时已大部分降解吸收;⑤结果显示氧化再生纤维素止血材料能有效防止猪肝脏创面出血,且应用安全可靠。BACKGROUND:At present,plant-derived absorbable hemostats are mainly imported,so it is necessary to develop domestic alternatives that are not inferior to similar imported products.OBJECTIVE:To investigate the hemostatic effect of oxidized regenerated cellulose hemostatic material on a model of minipig liver hemorrhage.METHODS:A total of 24 Bama minipigs were selected and randomly divided into three groups.In the sham operation group(n=6),only an open operation was performed,and the damaged side of the liver was removed and put back in situ.In the experimental group(n=12),the liver hemorrhage model was established,and the oxidized regenerated cellulose hemostatic material was applied to the wound.In the control group(n=6),commercially available absorbable hemostatic gauze was used on the wound after establishing liver hemorrhage models.Hemostatic time and blood loss were recorded.The venous blood of the minipig anterior cavity was collected at different time points before and after modeling,and the blood routine and liver and kidney functions were analyzed.Hematoxylin-eosin staining and Masson staining were performed at 2,6,and 14 weeks after modeling.The main organs were observed by histopathology at 14 weeks after modeling.A liver ultrasound examination was performed at different time points after modeling to observe the degradation and absorption of materials.RESULTS AND CONCLUSION:(1)There was no significant difference in intraoperative hemostatic time and blood loss between the experimental group and the control group(P>0.05).(2)The monitoring results of blood biochemical indexes demonstrated that the levels of aspartate transaminase and glutamic pyruvic transaminase in the three groups were higher 24 hours after modeling than before modeling,and the indexes basically recovered to the normal levels 72 hours after modeling.There were no significant differences in blood biochemical indexes such as liver and kidney functions,blood glucose and inflammatory factors among the three groups(P>0.05).(3)Hematoxylin-eos

关 键 词：氧化再生纤维素 可吸收止血材料 肝脏出血创面 可吸收止血纱 动物模型 止血效果 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R-332