胶原蛋白海绵控制髋关节置换术后出血的应用

Application of collagen sponge in bleeding control after total hip arthroplasty

[目的]探讨胶原蛋白海绵在控制全髋关节置换术后出血中的有效性与安全性。[方法]选取2014年8月~2015年8月行髋关节置换术的患者150例,随机分为两组:胶原蛋白海绵组75例,使用胶原蛋白海绵;空白对照组75例,未予使用。记录每个患者术后可见失血量、术中失血量、总失血量、术前术后血红蛋白值、两组中的输血患者数及并发症等。[结果]胶原蛋白海绵组术后可见失血量为(364.01±38.19)ml,空白对照组为(380.08±40.41)ml,差异无统计学意义;胶原蛋白海绵组术中失血量为(481.70±82.92)ml,空白对照组为(497.28±90.57)ml,差异无统计学意义;两组总失血量分别为(1 250.73±266.10)ml和(1 552.69±276.32)ml,差异有统计学意义;两组术后24 h血红蛋白下降值分别为(34.20±3.79)g/L、(42.64±5.12)g/L,差异有统计学意义;两组分别有22例和37例患者术后输血,差异有统计学意义;两组各有1例患者切口近端表浅皮肤坏死合并感染,空白对照组中有1例发生深静脉血栓,差异无统计学意义(P=1.000)。[结论]医用胶原蛋白海绵可以有效降低THA的术后失血量。

[Objective] To investigate the effect and safety of medical collagen sponge in controlling post- operative bleeding following total hip arthroplasty. [Methods] One hundred and fifty patients were recruited between August 2014 and August 2015 and were randomly assigned to two groups prior to conventional hip replacements. The collagen sponge group had75 cases using medical collagen sponge during the surgery. The control group had 75 cases without using collagen sponge. Each patient was monitored and recorded for visible blood loss, intra-operative blood loss, total blood loss, and pre- and post-operative hemoglobin levels. In addition, the number of patients accepting blood transfusion in the 2 groups, as well as complications,were also recorded. [Results] The visible blood loss after surgery was（364.01±38.19） ml in the collagen sponge group,which was not significantly different from（380.08±40.41） ml in the control group. The intra-operative blood loss in collagen sponge group was（481.70±82.92） ml, not significantly different from（497.28±90.57） ml in the control group. Total blood loss in the collagen sponge group and control group patients were（1 250.73±266.10） ml and（1 552.69±276.32） ml, respectively, with a significant difference between the two groups. The 24-hour hemoglobin drop for the two groups was（34.20±3.79） g/L and（42.64±5.12） g/L, respectively, with a significant difference between the two groups. The collagen spongegroup had 22 cases requiring post-operative blood transfusion, versus 37 cases in the control group; there was a significant difference between the two groups. During postoperative care, there was 1 patient with deep venous thrombosis in the control group, and there was 1 patient with superficial skin necrosis and infection at the proximal incision site in each group; there were no significant differences between the two groups. [Conclusion] The use of medical collagen sponge can effectively reduce post-operative blood loss after total hip knee arthroplasty.