医用胶原蛋白海绵治疗重度肝破裂的临床研究

目的探讨医用胶原蛋白海绵片在重度肝破裂创面的止血性能、封闭创面的效果及肝组织修复状况。方法将重度肝破裂患者以入院先后为序,随机分成实验组68例和对照组64例,实验组用医用胶原蛋白海绵片对肝创面进行止血和填塞;对照组用明胶海绵片处理肝破裂创面。结果在肝破裂创面,两种止血材料均能即刻止血。医用胶原蛋白海绵片与创面紧密粘附,而明胶海绵片较易脱落。且研究组的止血时间(19.65+1.28)min及术中出血量(301.57+56.18)ml均少于对照组(P<0.05),术后腹腔引流量(380.45+12.34)ml并发胆漏及再出血均少于对照组(P<0.05),术后住院时间(24.01+4.89)d短于对照组(P<0.05)。术后CT复查显示研究组创面肝组织修复时间(30.30+6.42)d短于对照组(P<0.05)。结论胶原海绵片能有效地对肝创面止血,与创面的粘附力强,且能诱导肝创面肝细胞再生。术后胆漏及再出血等并发症少,术后恢复快。胶原海绵片是一种安全的局部止血、组织封闭和促进肝细胞再生的生物材料,在肝破裂中的临床应用具有一定的推广价值。

Objective To investigate the effects of hemostatic and sealing surface of aound,and recovery of liver tissue.Methods In the treatment of 132 patients with severe hepatic trauma, 68 cases were randomly enrolled in experiment group treated with collagen sponge,while the others in control group treated with common used gelatin sponge. Results In the incision of hepatic surface, the two kinds of hemostatic material could stop the bleeding immediately.the collagen sponge was adhered to the incision closely. However,the gelatin sponge was deciduous easily.In the hemostatic time,hemorrhagic volume,abdominal cavity drainage,recovery time of hepatic tissue,postoperation complications(re-bleeding,hepatobiliary leakage),and stay hospital time the experiment group was superior to the control group (P<0.05 ).Conclusions The collagen sponge can effect to hemostasis. It is closely adhered to surface of wound and is absorbed quickly, it can induce regeneration of hepatic cells and the postoperation complication was few and recovery of post-operation was fast. the collagen sponge possesses a good effects in the local hemostasis, sealing tissue and stimulated hepatic cell regeneration,so it is a excellent iologic material.