生物医用可吸收止血材料的研究与临床应用

Research and clinical application of biomedical absorbable hemostatic materials

背景:对于凝血功能障碍和实质性脏器出血的患者,单单使用常规外科技术止血不能起到很好的效果,因此医用可吸收止血材料的研究和应用得到了快速的发展。目的:回顾临床常用可吸收止血材料的研究现状,为临床医生合理应用止血材料提供指导。方法:应用计算机检索CNKI和PubMed数据库中2000-02/2010-02关于止血材料的文章,在标题和摘要中以"生物材料;止血材料;生物可吸收材料;止血效果;止血机制"或"biomaterial;hemostatic material;bioresorbable material;hemostasis effect;hemostatic mechanism"为检索词进行检索。文献检索语种限制为英文和中文。选入文章内容与生物可吸收止血材料及其应用有关,同一领域文献则选择近期发表或发表在权威杂志文章。文献类型包括综述和临床研究。排除重复研究及内容与研究目的不相符的文献。结果与结论:通过对文献的复习可知,近年来国内外主要应用的可吸收止血材料包括纤维蛋白胶、氧化纤维素和氧化再生纤维素、α-氰基丙烯酸酯类组织胶、可吸收性明胶海绵、微纤维胶原等。不同的止血材料其止血机理和止血效果均不相同,只有在充分的了解各种止血材料性能的基础上合理选择使用止血材料,才能在临床工作中得到事半功倍的效果。

BACKGROUND： Some patients with coagulation disorders and substantiality abdomen viscera trauma cannot stop bleeding when using conventional surgical techniques alone, so the biomedical research and clinical application of absorbable hemostatic materials have been rapidly developed. OBJECTIVE： To review the research status of clinical absorbable hemostatic materials in recent years, and to provide guidance to clinicians. METHODS： The database of PubMed and CNKI from February 2000 to February 2010 was retrieved on computer using key words of biomaterial, hemostatic material, bioresorbable material, hemostasis effect, hemostatic mechanism. The literature was limited to English and Chinese languages. Literatures concerning application of biomedical absorbable hemostatic materials were included, consisting of reviews and clinical experiments. Other papers about duplicated study and contents inconsistent with the research purpose were excluded. RESULTS AND CONCLUSION： Based on literature review, the bioabresorbable hemostasis materials include fibrin glue, oxidized regenerated cellulose and oxidized cellulose, a-cyano-acrylate tissue adhesive, abresorbable gelatin sponge, microfiber collagen. Different hemostatic materials are varied in the hemostatic mechanism and hemostatic effect, only fully understanding the performance of various hemostatic materials can achieve very efficient outcomes in clinical practice.