创伤急救止血粉的研制与应用

Development and application of traumatic emergency hematopoietic powder

目的 探讨以马铃薯变性淀粉和海藻酸钠为原料制备一种可吸收创伤急救止血粉的方法及用途,解决不可吸收止血材料应用于出血创面存在潜在的安全隐患。方法 首先将马铃变性淀粉经过糊化、交联、穿孔制备成微孔多聚糖乳浊液;其次将海藻酸钠微球粉末用制孔剂Na Cl溶液充分溶解,配制成海藻酸钠溶液,将配制的海藻酸钠溶液放入自制的容器中加入Ca Cl2溶液进行交联固化,制备成微孔海藻酸钙乳浊液;将2种乳浊液按照1∶1体积比,采用直接法或乳化法合成复合创伤急救止血粉;经40目的微孔筛筛分,在无菌条件下包装,60Co灭菌。结果 止血粉中微孔多聚糖含量为45%~55%,含钙量为5%~10%;重金属含量小于百万分之二十,吸水倍率为20~30倍;扫描电子显微镜下见止血粉为圆形或椭圆形微球状,微球的直径为10~380μm;动物实验研究显示最快止血时间为7 s,最慢止血时间为50 s,3 min在创面表面形成止血膜;将止血粉直接喷洒于软组织出血创面,具有止血、消炎、促进创面愈合的功效。结论 创伤急救止血粉应用于各种软组织出血创面,可迅速吸收伤口渗出液,形成水合凝胶保护创面。具有双重止血、双重保护创面、双重促进创面愈合,有效阻止疤痕组织增生。

Objective To explore the preparation and application of a kind of absorbable and haemostatic powder for traumatic management with modified potato starch and sodium alginate as raw materials,and to solve the potential safety hazard in the application of non?absorbable haemostatic materials to bleeding wound surface.Methods As a first step,the modified starch was gelatinized,colloided and perforated to prepare into a microporous polysaccharide emulsion.Then,sodium alginate microsphere powder was fully dissolved in the pore?making agent NaCl solution to prepare sodium alginate solution.The prepared sodium alginate solution was put into a self?made container and then was added with CaCl2 solution for cross?linking and curing.Thus,calcium alginate emulsion with micro?pores was successfully prepared.With a volume ratio of 1∶1,the compound haemostatic powder for traumatic management was synthe?sized by the direct method or emulsification method.Finally,the obtained substance was screened by a 40 microporous sieve,packed in aseptic conditions and sterilized with 60 Co.Results The amounts of microporous polysaccharide and calcium in the haemostatic powder were 45%?55%and 5%?10%respectively.The amount of heavy metal was less than 20 parts per million,and the rate of water absorp?tion was 20?30 times.Electron microscopic scanning showed that the haemostatic powder had round or elliptical microsphere shapes,with a diameter of 10?380μm.Animal experimental research indicated that the shortest haemostatic time was 7 seconds,and the slowest haemostatic time was 50 seconds,and a haemostatic membrane could be formed on the wound surface within 3 minutes.Applied directly on the wound surface of soft tissues,the haemostatic powder could produce the effects of hemostasis,anti?inflammation and promotion of wound healing.Conclusion The haemostatic powder for trauma management applied to wound surface of various soft tissues could rapidly absorb wound exudate and formed a wound surface protection hydrated gel,with the advantages of double hemostasis,double wound surface protection,double promotion of wound surface healing and effective prevention of scar tissue hyperplasia.