CAJ | 학술논문

目的评价外用人凝血酶与可吸收止血材料联合用于手术创面的止血作用和安全性.方法采用前瞻随机分组对照的方法,对例手术的患者随机分为试验组和两对照组. A组外科手术病人渗血创面,取冻干人凝血酶1000IU/支(用量根据手术创面面积),用灭菌氯化钠注射液溶解成50~200u/ml的溶液喷雾或用干粉喷洒于创面;B组手术创面经止血后渗血创面敷以胶原蛋白海绵,再覆盖干纱布并以适当力量加压;C组手术创面经止血后渗血创面先局部凝血酶,剂量同A组,表面再敷以胶原蛋白海绵.对比观察创面出血的止血时间出血量和单位面积出血量、24h和48h腹腔引流量以及凝血指标和肝肾功能等安全性指标.结果研究组创面止血时间为(61.4±18.5)s,创面出血量(13.7±2)g,创面单位面积出血量(0.6±0.4)g/cm 2;24h和48h腹腔引流量为(53±30)ml,(23±10)ml,明显低于两对照组,两者比较差异均有显著性.研究期间,所有患者未出现任何局部或全身不良事件;凝血指标和肝肾等主要脏器功能的变化不明显,未发现由药物相互作用引发的不良反应.结论凝血酶与可吸收止血材料联合应用于手术创面出血有较好的止血作用和安全性.
목적평개외용인응혈매여가흡수지혈재료연합용우수술창면적지혈작용화안전성.방법채용전첨수궤분조대조적방법,대례수술적환자수궤분위시험조화량대조조. A조외과수술병인삼혈창면,취동간인응혈매1000IU/지(용량근거수술창면면적),용멸균록화납주사액용해성50~200u/ml적용액분무혹용간분분쇄우창면;B조수술창면경지혈후삼혈창면부이효원단백해면,재복개간사포병이괄당역량가압;C조수술창면경지혈후삼혈창면선국부응혈매,제량동A조,표면재부이효원단백해면.대비관찰창면출혈적지혈시간출혈량화단위면적출혈량、24h화48h복강인류량이급응혈지표화간신공능등안전성지표.결과연구조창면지혈시간위(61.4±18.5)s,창면출혈량(13.7±2)g,창면단위면적출혈량(0.6±0.4)g/cm 2;24h화48h복강인류량위(53±30)ml,(23±10)ml,명현저우량대조조,량자비교차이균유현저성.연구기간,소유환자미출현임하국부혹전신불량사건;응혈지표화간신등주요장기공능적변화불명현,미발현유약물상호작용인발적불량반응.결론응혈매여가흡수지혈재료연합응용우수술창면출혈유교호적지혈작용화안전성.
Objective To evaluate the efficacy and safety about combined application of thrombin and absorb hemostatic materi -als in operation wound hemostasis.Methods With prospective randomized control method ,all the cases were randomly divided into treatment group and two control group.Group A:for the ooze blood wound of surgery patient ,lyophilized people thrombin 1000 Iu/branch was taken, sterilization sodium chloride injection which was melt into 50~200units/ml solution was used,then spraiedor dried powder was sprayed on the wound;Group B:ooze blood wound was applied with hemostatic collagen sponge and dry gauze combined with proper strength ;group C:af-ter the bleeding local thrombin was applied to wound ooze blood ,the dose was the same with group A,collagen sponge was applied to the wound surface.The amount of bleeding in the hemostatic time of wound bleeding and the amount of bleeding in unit area were observed con -trastly,celiac lead flow,blood coagulation indexes and liver/kidney safety index,etc after 24h and 48h were observed.Results Bleeding time of the wound was (61.4 ±18.5)s,the amount of bleeding was (13.7 ±2)g,the amount of bleeding in the unit area was (0.6 ±0.4)g/cm 2;celiac lead flow after 24h and 48h was (53 ±30)ml and (23 ±10)ml,less than two control groups significantly ,there was statistical signifi-cance.During the study period,all the patients failed to show any local or systemic adverse events;there was not obvious change in blood co-agulation indexes,liver,kidney and other major viscera function ,there was also not adverse reactions caused by drug interaction .Conclusion Combined application of thrombin and absorb hemostatic materials in operation wound hemostasis have better hemostatic effect and safety .