一种适用于战创伤致命性大出血止血材料的研发

Development of a hemostatic material suitable for fatal bleeding in war trauma and injuries

现代科技战争战创伤种类多样、伤情重且复杂。战创伤大出血已成为平战时致残、致死的重要原因。快速止血是战创伤六大救治技术中挽救伤员生命的关键措施之一。无机材料沸石可产生高温造成继发损伤,壳聚糖止血粉在动静脉大出血中止血效果不佳。解放军总医院第四医学中心全军烧伤研究所所长柴家科教授领衔的团队,与军地相关研究机构合作,通过研究弹药火器伤的致伤机制和战创伤救治技术,研制出一种战创伤快速有效止血新材料,并对其结构、理化性能、表征、生物相容性、体外凝血实验等进行评价。本产品具有海绵互穿孔道结构,能成功将聚丙烯酸钠接枝到壳聚糖上,在不同的介质中都具有很强的局部凝血功能、吸水能力,无细胞毒性和致敏性。利用该材料覆盖65 kg白猪股动脉出血、贯穿伤出血和爆炸伤肢体残端出血,按压2~3 min,观察10 min,无继发性出血,止血效果显著。该止血材料通过了产品性能和生物学注册检测,适于平战时伤员大出血止血及自救互救,第一时间挽救生命,为后续救治赢得宝贵时间,明显降低伤亡率、伤残率,提升平战时战创伤救治水平。

Traumas and injuries nowadays in modern wars are full of diversity,severity and complexity.The traumatic hemorrhage has become an important cause of disability and death during the war and the peaceful time.Rapid hemostasis treatment is one of the key measures to save the lives of the wounded in the 6 rescue techniques.Inorganic materials like zeolite could produce secondary damage caused by high temperature.Chitosan hemostatic powder has poor hemostatic effect in arteriovenous hemorrhage.In order to solve the problems of hemostasis treatment,Prof.Chai Jiake,the director of Burn Institute,Fourth Medical Center of the PLA General Hospital,cooperated with military-related research institutes to develop a war wound with fast and effective hemostatic new materials,leading the research on the injury mechanism and battlefield treatment technology of ammunition firearm injuries.The structure,physical and chemical properties,biocompatibility and in vitro coagulation experiments were evaluated.The product has a sponge interpenetrating channel structure,and successfully grafts sodium polyacrylate onto chitosan,which has strong local coagulation ability and water absorption capacity,no cytotoxicity and sensitization.The material was tested on 65 kg pigs to cover the femoral artery,penetration wounds,and the bleeding of the limb of the explosive wounds.The wounds with the materials were all pressed for 2-3 minutes,with no secondary bleeding observed for over 10 minutes.The hemostatic effect was remarkable.The materials,which have passed product performance and biological registration testing,were proved to be suitable for the self-rescue and mutual rescue of the wounded,saving lives at the first time,winning precious time for follow-up treatments.The hemostatic material could significantly reduce the casualties and disability rates,improving the treatment standards and abilities of bleeding.