一种多孔可吸收明胶海绵止血材料应用优势比较

Clinical nursing study on hemostasis of absorbable gelatin sponge in internal fixation of femoral neck fracture

探讨可吸收性明胶海绵材料止血应用中效果。采用前瞻性病例对照研究方法,随机分为观察组(使用明胶海绵止血)和对照组(使用止血粉进行止血)。观察2种止血材料的术中使用效果,并分别比较2组的术中止血时间、术中出血量以及术后3 d引流量。结果表明,2组在使用止血材料后收缩压、舒张压均较使用前明显上升(P<0.05),使用后心率均明显下降(P<0.001);观察组术中止血时间、出血量和术后3 d引流量分别为(2.65±0.43)min、(105.55±20.53)mL和(66.38±20.07)mL;对照组术中止血时间、出血量和术后3 d引流量分别为(4.16±1.35)min、(210.65±25.85)mL和(151.76±35.33)mL,且组间比较差异均具有统计学意义(P<0.001)。2种止血材料均在成人股骨颈骨折内固定术中有着安全可靠的止血效果,相较止血粉,可吸收明胶海绵能够缩短术中止血时间,减少术中出血量和术后3 d引流量,其有着更好的止血效能。

To investigate the hemostatic effect of absorbable gelatin sponge in internal fixation of femoral neck fracture with dynamic hip screw and anti rotation screw.Methods Using a prospective case-control study method, 160 adult patients with femoral neck fracture who were treated by internal fixation with hip screw and anti rotation screw in our orthopaedic department from January 2018 to January 2021 were selected as the study objects, and randomly divided into the observation group(hemostasis with gelatin sponge during operation, n=80) and the control group(hemostasis with hemostatic powder during operation, n=80).To observe the hemostatic effect of the two hemostatic materials during the operation, and compare the hemostatic time, the amount of bleeding during the operation and the drainage volume 3 days after the operation of the two groups of patients.Results The systolic blood pressure and diastolic blood pressure of the two groups increased significantly after the use of hemostatic materials(P<0.001),and the heart rate decreased significantly after the use(P<0.001).In the observation group, the time of hemostasis during operation, the amount of bleeding during operation, and the volume of drainage 3 days after operation were(2.65±0.43) min,(105.55±20.53) ml,(66.38±20.07) ml, respectively;The patients in the control group were(4.16±1.35) min,(210.65±25.85) ml and(151.76±35.33) ml, respectively, with statistically significant differences between groups(themostatic time=9.532,Phemostatic time<0.001;tbleeding volume=28.477,Pbleeding volume<0.001;tdrainage volume=18.794,Pdrainage volume<0.001).Conclusion Both hemostatic materials have safe and reliable hemostatic effect in internal fixation of adult femoral neck fracture.Compared with hemostatic powder, absorbable gelatin sponge can shorten the hemostatic time during operation, reduce the amount of bleeding during operation and the volume of drainage 3 days after operation, and has better hemostatic efficacy.