羧化多糖可吸收止血纱对兔肝、脾创面的止血效果评估

Evaluation of hemostatic effect with carboxy polysaccharide absorbable hemostatic gauze on liver and spleen wound of rabbits

目的评估羧化多糖可吸收止血纱(其编号为NWL-K)对兔肝、脾创面的止血效果。方法60只新西兰兔按随机数字表法分为两组,每组30只,分别建立肝和脾创面出血模型;两组模型再根据使用止血材料的品种,分成普通纱布组、速即纱组和NWL-K组,每组10只。采用造模出血量和切除肝组织重量评估模型稳定性。脾脏出血模型按压3 min后每隔(30±5)s以及肝脏出血模型按压30 s后每隔(20±5)s分析各组止血时间和止血评分,观察创口与纱布的黏合情况。结果各肝脏、脾模型组造模时出血量比较,差异无统计学意义(P>0.05),造模时肝脏组织切除重量比较,差异均无统计学意义(P>0.05),说明模型造模稳定,对之后的止血实验不产生影响。在脾脏创面出血模型止血时间上,NWL-K组[210(180,248)s]、速即纱组[255(233,300)s]分别与普通纱布组[465(383,660)s]比较差异有统计学意义(P<0.05),NWL-K组相较于速即纱组止血时间更短(P<0.05)。在肝脏创面出血模型止血时间上,NWL-K组[70(70,95)s]、速即纱组[90(85,110)s]分别与普通纱布组[250(225,290)s]比较差异有统计学意义(P<0.05)。脾脏模型各观察时间点速即纱组、NWL-K组止血评分下降快于普通纱布组差异有统计学意义(P<0.05),180 s时NWL-K组和速即纱组比较,差异有统计学意义(P<0.05)。肝脏模型50,70,90 s时速即纱组、NWL-K组止血评分下降快于普通纱布组差异有统计学意义(P<0.05)。30,110,130 s时普通纱布组与NWL-K组比较,差异有统计学意义(P<0.05)。NWL-K吸水性和周围组织黏合性均优于普通纱布和速即纱。结论对于肝、脾出血创面,与其他类型纱布比较,应用NWL-K能有效缩短止血时间,减少出血量;NWL-K吸水性强,与创口黏合稳固。

Objective To evaluate the hemostatie fficacy of N-carboxyethylchitosan fiber gauze(numbered NWLK)in a leporine bleeding wounds of intraperitoneal parenchymel viscenal.Methods Sixty New Zealand rabbits were divided into two groups acconding to the randomized digital mumber method,with 30 rabbits per group.The leporine bleeding models of hepatic or splenic wound were made respectively.The two groups were subdivided into three groups:common gauze group,SURGICEL group and NWL-K group,with 10 rabbits per goup.By analyzing the weight of excised liver tssue and amount of bleeding,the model stability was measured.The time to hemostasis and bleeding score in each group were analyzed every(20±5)seconds after compression for 30 seconds in the hepatic bleeding models or every(30±5)seconds after compression for 3 minutes in the splenie bleeding models.The adhesion between wound and gauze was evaluated at the same time.Results There was no significant difference in the weight of excised liver tsse and amount of bleeding when the hepatic or splenice bleeding models were made(P>0.05).It showed that the model was made stably and the hemostasis experiment would not be afected.In the splenic wound moodel experiment,the time to hemostasis was 255(233.30)sconds in SURGICEL group and 210(180,248)seconds in NWL-K group,both of which were significantly shorter than 465(383,660)seconds in common guaze group(P<0.05).NWL-K achieved shorter time to hemostasis than SURGICEL(P<0.05).In the hepatic wound model experiment,the.time to hemostasis was 90(85,110)seconds in SURGICEL group and 70(70,95)seconds in NWL-K group,both of which were signifiantly shorter than 250(225290)seconds in common gauze group(P<0.05).In the splenie wound model experiment,the bleeding score in NWL-K group and SURGICEL group decreased faster than that in common gauze goup(P<0.05).The diference of bleeding score was significant between NWL-K group and SURGICEL group at 180 seconds(P<0.05).In the hepatic wound model experiment,the bleedling score in NWL-K group and SURCICEL goup decreased faster than that in common gauze group at 50 seconds,70 seconds and 90 seconds(P<0.05).The bleeding score in common gauze group and NWL-K group showed significant difference at 30 seconds,110 seconds and 130 seconds(P<0.05).For the adhesion evaluation,both the water-absorbency and adhesion to tissue of NWLK were better than common gauze and SURGICEL.Conclusions For hepatie and splenic bleeding wounds,compared with other types of gauze,the application of NWL-K can efectively shorten the time to hemostasis and reduce the blood loss.The NWL-K shows high water-absorbency and firm adhesion to bleeding wound.