复合微孔多聚糖可减少髋关节置换中的出血

Microporous polysaccharide hemospheres reduce blood loss in total hip arthroplasty

背景:国外动物实验和临床报道复合微孔多聚糖止血效果佳,无迟发性出血发生,并具有良好的组织相容性,对机体无不良反应。目的:分析应用复合微孔多聚糖止血粉减少全髋人工关节置换后失血的疗效和安全性。方法:选择因单侧股骨颈骨折行全髋关节置换患者98例,其中男39例,女59例,年龄61-77岁,采用随机数字表法均分为2组,试验组在行生物型髋关节假体置换缝合伤口前,将复合微孔多聚糖1g直接喷涂在出血部位,放置引流管;对照组缝合前在出血部位仔细电凝止血,放置引流管。记录两组治疗前后血红蛋白水平、失血量、输血率、引流量、凝血指标及下肢深静脉血栓发生率。结果与结论:试验组总失血量、引流量及输血率明显低于对照组(P<0.01),两组治疗后24 h的D-二聚体、血小板计数、活化部分凝血活酶时间值及国际标准化比值比较差异均无显著性意义;两组各1例发生下肢深静脉血栓,下肢深静脉血栓率比较差异无显著性意义;两组均未发生浅表及深部感染现象。表明复合微孔多聚糖止血粉能明显减少单侧全髋关节置换的出血,并具有安全、高效、便捷的特点。

BACKGROUND：In foreign animal experiments and clinical reports, microporous polysaccharide hemospheres are characterized as good hemostatic effect, no delayed bleeding, good biocompatibility, and no adverse reactions in the body. OBJECTIVE：To assess the efficacy and safety of microporous polysaccharide hemospheres on reducing blood loss after unilateral total hip arthroplasty. METHODS：Totaly 98 patients who received unilateral total hip arthroplasty due to femoral neck fractures, 39 males and 59 females, aged 61-77 years, were randomly divided into two groups： test group, treated with 1g microporous polysaccharide hemospheres before suture of wound; control group, treated with electric coagulation hemostasis before suturing. Drainage tubes were placed in the two groups. Hemoglobin, blood loss, alogeneic transfusion rate, drainage volume, coagulation index and incidence of deep venous thrombosis of the lower limbs were compared. RESULTS AND CONCLUSION：The total blood loss, drainage volume, and transfusion rate in the test group were significantly lower than those in the control group （P 〈 0.01）, but there were no differences in D-dimer, platelet count, activated partial thromboplastin time and international normalized ratio between the two groups. One case of each group developed deep venous thrombosis of the lower limbs, and no significant difference was＆nbsp;in the incidence of deep venous thrombosis between the two groups. No infection occurred. These findings indicate that microporous polysaccharide hemospheres that are safe, effective and convenient can reduce the visible and hidden blood loss after unilateral total hip arthroplasty.