战伤快速止血材料发展回顾与展望

Review and prospect of development of haemostatic materials for first aid in battlefields

本文综述国内外战伤止血材料的机理研究和实际应用效果,以期为高效战伤止血材料研发提供参考。回顾不同时期止血材料的机理研究成果和止血效果改进方法:包括冷兵器时期,止血材料开始用于战争中的伤员;现代火器时代,止血材料被用于子弹或炮弹碎片损伤者;现代战争新概念武器时期,止血材料被用于激光武器或粒子束武器伤害的伤员;尤其是近几十年来,壳聚糖和沸石纱布、纤维素类止血材料、α氰基丙烯酸酯类止血材料用于伤员。结果发现:加压包扎止血是现场急救的遵循的基本原理;纯棉制成的棉敷料或三角巾是应用最广泛的战伤止血材料,橡胶止血带或卡式止血带是现场处理致命性出血的最后工具;壳聚糖或沸石粉等止血剂是新研发装配的增效止血材料,能降低现场失血造成的死亡率,提高抢救的成功率。通过总结历史上不同时期止血材料的发展规律,可以预测加载止血活性药物的特种敷料是未来快速止血材料的研发路径。在目前纺织技术条件下,由载沸石纤维与载银棉纤维混纺制作的三角巾有望成为一种具有抗菌作用的新型止血材料被生产与应用,其专利申请已在中国受理。

This paper reviewed the mechanism, and practical application of haemostatic materials for the first aids on the batteefield, to provide references for developing efficient battle wound haemostatic materials. A review of the results of research into the mechanism of haemostatic materials and methods of improving their effectiveness in different periods: haemostatic materials began to be used on casualties in warfare since the Cold War period;the Modern Firearms era, when haemostatic materials were used on those injured by bullets or shell fragments;in the Modern Warfare New Concept Weapons period, such as laser weapons or particle beam weapons have been used;especially in recent decades, chitosan and zeolite gauze, cellulose-based haemostatic materials and alpha cyanoacrylate haemostatic materials have been used for the wounded in the battlefield. It has been found that impressive dressing on site is the basic principle;cotton dressings or triangles made of pure cotton are the most widely used haemostatic materials, rubber tourniquets or cassettes tourniquets are the last tools to deal with fatal bleeding;haemostatic agents such as chitosan or zeolite powder are newly developed and assembled booster haemostatic materials that can reduce the mortality caused by blood loss at the scene and increase the success rate of resuscitation.. By summarizing the development pattern of haemostatic materials in different periods, it can be predicted that special dressings loaded with hemostatic active drugs are the future development path for rapid haemostatic materials. Under the current textile technology, a triangle scarf made from a blend of zeolite fibres and silver-loaded cotton fibres is expected to be a new haemostatic material with an antibacterial effect to be produced and applied. Excitedly, its patent application has been accepted in China.