可溶性止血纱布对兔肝脏创伤的止血作用

Hemostatic effect of soluble hemostatic gauze on liver trauma in rabbits

背景:改性纤维素敷料是多糖类止血材料的重要组成部分,其与明胶海绵和生物蛋白胶相比更具有其独特的优势。目的:对比普通医用纱布、可吸收性止血纱布及可溶性止血纱布的止血效果及组织相容性。方法:将36只新西兰兔,制备肝脏创伤模型,随机分为3组,实验组采用可溶性止血纱布(主要成分为羧甲基纤维素钠)止血,纱布不取出;对照组采用可吸收止血纱布(主要成分为羧甲基纤维素钠)止血,纱布不取出;空白组采用普通医用纱布止血,止血后取出纱布。观察各组出血时间与出血量;止血后1,3,7,10 d,取兔肝脏创伤部位愈合组织进行病理学观察。结果与结论:(1)出血时间:实验组、对照组出血时间少于空白组(P<0.05),实验组与对照组出血时间比较差异无显著性意义;(2)出血量:实验组、对照组出血量少于空白组(P<0.05),实验组与对照组出血量比较差异无显著性意义;(3)材料吸收:可溶性止血纱布置入1 d时基本吸收,无残留;可吸收性止血纱布置入10 d时基本吸收,无明显残留;(4)病理观察结果:实验组和对照组的组织病理变化基本相同,10 d时创面周围组织炎症反应较7 d时轻,肝组织轻度纤维化,纤维瘢痕形成,创面愈合;空白组创面周围组织可见轻度水肿,无其他明显异常病变;(5)结果表明:可溶性止血纱布具有较好的止血效果和组织相容性。

BACKGROUND：Modified cel ulose dressing as an important part of polysaccharide hemostatic material has its unique advantages compared with gelatin sponge and fibrin glue. OBJECTIVE：To compare the hemostatic effect and histocompatibility of medical gauze, absorbable hemostatic gauze and soluble hemostatic gauze. METHODS：After establishment of liver trauma models, 36 New Zealand rabbits were randomly divided into three groups （n=12） depending on different hemostatic materials. Injury wounds were covered with soluble hemostatic gauze （mainly made of sodium carboxymethyl cel ulose, experimental group）, absorbable hemostatic gauze （mainly made of sodium carboxymethyl cel ulose, control group） and medical gauze （normal group）, respectively. The gauze was only taken out in the normal group. A hemostasis trial on liver injury was carried out to investigate the bleeding time and bleeding amount. After 1, 3, 7 and 10 days, wound healing was observed histological y in each group. RESULTS AND CONCLUSION：The bleeding time and bleeding amount in the experimental and control groups were lower than those in the normal group （both P〈0.05）, but no statistical difference was found between the experimental and control groups. After 1 day of implantation, the soluble hemostatic gauze was absorbed completely, and the absorbable hemostatic gauze was absorbed with no residual until the 10th day. Experimental and control groups shared similar pathological changes. In these two groups, mild fibrosis and fibrous scar appeared, a better improvement in wound inflammation was shown at 10 days compared with that at 7 days, and the wound gradual y healed. In the normal group, there were no obvious lesions except mild tissue edema around the wound. Al these findings suggest that the soluble hemostatic gauze has better hemostatic effect and histocompatibility.