Enhanced wound healing and hemostasis with exosome-loaded gelatin sponges from human umbilical cord mesenchymal stem cells

BACKGROUND Rapid wound healing remains a pressing clinical challenge,necessitating studies to hasten this process.A promising approach involves the utilization of human umbilical cord mesenchymal stem cells(hUC-MSCs)derived exosomes.The hypothesis of this study was that these exosomes,when loaded onto a gelatin sponge,a common hemostatic material,would enhance hemostasis and accelerate wound healing.AIM To investigate the hemostatic and wound healing efficacy of gelatin sponges loaded with hUC-MSCs-derived exosomes.METHODS Ultracentrifugation was used to extract exosomes from hUC-MSCs.Nanoparticle tracking analysis(NTA),transmission electron microscopy(TEM),and western blot techniques were used to validate the exosomes.In vitro experiments were performed using L929 cells to evaluate the cytotoxicity of the exosomes and their impact on cell growth and survival.New Zealand rabbits were used for skin irritation experiments to assess whether they caused adverse skin reactions.Hemolysis test was conducted using a 2%rabbit red blood cell suspension to detect whether they caused hemolysis.Moreover,in vivo experiments were carried out by implanting a gelatin sponge loaded with exosomes subcutaneously in Sprague-Dawley(SD)rats to perform biocompatibility tests.In addition,coagulation index test was conducted to evaluate their impact on blood coagulation.Meanwhile,SD rat liver defect hemostasis model and full-thickness skin defect model were used to study whether the gelatin sponge loaded with exosomes effectively stopped bleeding and promoted wound healing.RESULTS The NTA,TEM,and western blot experimental results confirmed that exosomes were successfully isolated from hUC-MSCs.The gelatin sponge loaded with exosomes did not exhibit significant cell toxicity,skin irritation,or hemolysis,and they demonstrated good compatibility in SD rats.Additionally,the effectiveness of the gelatin sponge loaded with exosomes in hemostasis and wound healing was validated.The results of the coagulation index experiment indicated that the gelatin sponge loaded with exosomes had significantly better coagulation effect compared to the regular gelatin sponge,and they showed excellent hemostatic performance in a liver defect hemostasis model.Finally,the full-thickness skin defect healing experiment results showed significant improvement in the healing process of wounds treated with the gelatin sponge loaded with exosomes compared to other groups.CONCLUSION Collectively,the gelatin sponge loaded with hUC-MSCs-derived exosomes is safe and efficacious for promoting hemostasis and accelerating wound healing,warranting further clinical application.

Comparison of ethanol-soaked gelatin sponge and microspheres for hepatic arterioportal fistulas embolization in hepatic cellular carcinoma

Hepatic arterioportal fistulas(APFs)are common in hepatocellular carcinoma(HCC).Moreover,correlated with poor prognosis,APFs often complicate antitumor treatments,including transarterial chemoembolization(TACE).AIM To compare the efficacy of ethanol-soaked gelatin sponges(ESG)and microspheres in the management of APFs and their impact on the prognosis of HCC.METHODS Data from patients diagnosed with HCC or hepatic APFs between June 2016 and December 2019 were retrospectively analyzed.Furthermore,APFs were embolized with ESG(group E)or microspheres(group M)during TACE.The primary outcomes were disease control rate(DCR)and objective response rate(ORR).The secondary outcomes included immediate and first follow-up APF improvement,overall survival(OS),and progression-free survival(PFS).RESULTS Altogether,91 participants were enrolled in the study,comprising 46 in group E and 45 in group M.The DCR was 93.5%and 91.1%in groups E and M,respectively(P=0.714).The ORRs were 91.3%and 66.7%in groups E and M,respectively(P=0.004).The APFs improved immediately after the procedure in 43(93.5%)patients in group E and 40(88.9%)patients in group M(P=0.485).After 2 mo,APF improvement was achieved in 37(80.4%)and 33(73.3%)participants in groups E and M,respectively(P=0.421).The OS was 26.2±1.4 and 20.6±1.1 mo in groups E and M,respectively(P=0.004),whereas the PFS was 16.6±1.0 and 13.8±0.7 mo in groups E and M,respectively(P=0.012).CONCLUSION Compared with microspheres,ESG embolization demonstrated a higher ORR and longer OS and PFS in patients of HCC with hepatic APFs.

Changes in the frequency of myeloid-derived suppressor cells after transarterial chemoembolization with gelatin sponge microparticles for hepatocellular carcinoma

Purpose: A series of clinical studies have established the safety and efficacy of transcatheter arterial chemoembolization(TACE) with gelatin sponge microparticles(GSMs) in treating hepatocellular carcinoma(HCC). HCC can lead to obvious necrosis inside tumors, especially larger ones, although it is unclear whether such necrotic tumor tissue can induce favorable immune reactions against the tumor. Myeloid-derived suppressor cells(MDSCs)have immunosuppressive functions and are currently considered a very important cell type affecting tumor immunity. This study observed changes in MDSC frequency in peripheral blood before and after GSM–TACE to evaluate the effect on the immune function of HCC patients.Methods: Eight patients diagnosed with HCC underwent GSM–TACE treatment in the Hepatobiliary Interventional Department of Beijing Tsinghua Chang Gung Hospital, Beijing, China;we followed up with the patients over a period of 30 days post-surgery. We used flow cytometry(FCM) to quantify the frequency of MDSCs in peripheral blood before TACE, 10 days after surgery and 30 days after surgery.Results: MDSC frequency after GSM–TACE had a significant downward trend. Pre-TACE, it was 30.73% ? 11.93%,decreasing to 18.60% ? 11.37% at 10 days after operation. This decrease was not statistically significant(P > 0.05). MDSC frequency was even lower 30 days after TACE(7.63% ? 7.32%) than at 10 days after TACE(P < 0.05), and there was a significant difference compared with pre-TACE(P < 0.001). We evaluated tumor response at 30 days after GSM–TACE according to the Modified Response Evaluation Criteria in Solid Tumors(mRECIST), and all eight patients showed partial response(PR).Conclusion: Our results confirmed that GSM–TACE was beneficial for improving anti-tumor immunity in the treatment of HCC.

Adsorption and Desorption Behaviors of Bovine Serum Albumin on Gelatin/Chitosan Sponge

Gelatin (Gel) and chitosan (CTS) have several biomedical applications because of their biodegradability and biocompatibility. Crosslinking of Gel and Gel/CTS systems was evaluated using N-acetyl-D-glucosamine (GlcNAc) formed into sponges by lyophilization. The prepared sponges were used to study the adsorption and desorption of fluorescein isothiocyanate (FITC) labeled bovine serum albumin (BSA) as a model instead of a growth factor. The effect of FITC-BSA concentration and temperature on the adsorption behavior of Gel/CTS sponges was investigated. The Langmuir adsorption isotherm model was used on the basis of the assumption that monolayer adsorption occurs on the surface;the results fit with the experiment data. The adsorption constants were 5.77 and 9.68 mL/mg for Gel and Gel/CTS sponges, respectively. The adsorption thermodynamic constants were found;adsorption onto sponges was an exothermic reaction. In particular, Gibbs free energy (ΔG) exhibited negative values in the range of 283 - 343 K for both Gel and Gel/CTS sponges, demonstrating the spontaneous nature of adsorption reaction. In addition, desorption behavior was evaluated for different concentrations and pH values of the FITC-BSA solution. The high adsorbed amounts of FITC-BSA on sponge resulted in high desorbed amounts in sponge, up to 55% from 3.5 mg/mL adsorbed concentration (around 1.5 mg from 3 mg adsorb amount). Desorption decreased following the buffer solution pH decrease, from 7.4 to 4 and 2 in Gel and Gel/CTS sponges, respectively. Based on the results of this preliminary study, these composite sponges could have significant application in biomedical materials.

鼻内镜下射频及明胶海绵局部填塞治疗顽固性鼻出血的临床研究

目的分析鼻内镜下射频及明胶海绵局部填塞治疗顽固性鼻出血的临床疗效。方法选取2021年6月至2023年6月抚州市第一人民医院收治的60例顽固性鼻出血患者作为研究对象,按照随机数字表法分为观察组与对照组,每组30例。观察组接受鼻内镜射频及明胶局部海绵填塞治疗,对照组接受单纯鼻内镜下射频治疗。比较两组临床疗效、治疗情况、生命质量、疼痛程度及并发症发生情况。结果观察组治疗总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05)。观察组出血量少于对照组,通气恢复时间、鼻黏膜恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组躯体功能、心理功能、社会功能、物质生活评分及总分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组视觉模拟评分法(VAS)均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为3.33%,低于对照组的20.00%,但组间比较差异无统计学意义。结论鼻内镜下射频及明胶海绵局部填塞治疗顽固性鼻出血患者效果显著,可改善患者生命质量,缓解疼痛,且安全性较高,值得临床推广应用。

兔毛角蛋白海绵的制备及其对亚甲基蓝的吸附研究

针对兔毛角蛋白资源浪费,采用冻融-干燥的方法制备了兔毛角蛋白海绵,通过红外光谱、X射线衍射、扫描电镜对其结构、形貌等进行表征。以亚甲基蓝为溶液,考察了角蛋白浓度、亚甲基蓝初始浓度、吸附时间对角蛋白海绵吸附性能的影响,结果表明,角蛋白海绵结构稳定且具有均匀的孔结构。角蛋白海绵对亚甲基蓝的吸附率随浓度增加而增加,当浓度为8%时,15min达到吸附平衡,且亚甲基蓝浓度30mg/L^(-1)时吸附率最大。角蛋白海绵对亚甲基蓝吸附过程符合二级动力学吸附模型,以化学吸附为主。

明胶海绵-血凝酶封堵剂在肺穿刺出血患者中的应用

目的 探讨明胶海绵-血凝酶封堵剂在肺穿刺出血患者中的应用。方法 收集2021年9月至2023年5月在济宁市第一人民医院接受明胶海绵-血凝酶封堵剂治疗的43例DSA导引肺穿刺活检并发出血患者临床资料,分析封堵止血治疗效果。结果 43例患者肺穿刺活检均成功取得,针道均由明胶海绵-血凝酶封堵剂成功封堵。封堵治疗后5 min,43例中仅1例术前表现为中量咯血伴中度出血影患者转为痰中带血,肺内出血影较5 min前稍扩大,其余患者均止血成功,咯血症状消失,肺内出血影与5 min前相仿。所有患者均未出现封堵治疗相关并发症。结论 明胶海绵-血凝酶封堵剂可用于治疗肺穿刺活检出血,疗效显著且安全。

MgH_(2)复合明胶海绵的制备及抑制变形链球菌的作用研究

目的通过将MgH_(2)微粒与临床常用的明胶海绵复合,制备MgH_(2)微粒复合明胶海绵研究其抗变形链球菌作用。方法使用硅烷偶联剂将氢化镁微粒分散在明胶海绵表面,并分别制备出MgH_(2)和明胶海绵质量比例为1∶8和1∶4的MgH_(2)复合明胶海绵。利用扫描电子显微镜观察MgH_(2)微米颗粒复合明胶海绵的微观结构和微粒分布。通过平板涂布实验,评估不同浓度MgH_(2)复合明胶海绵对变形链球菌的抑制效果。通过噻唑蓝(MTT)比色法评估MgH_(2)微粒和MgH_(2)复合明胶海绵与成纤维细胞共培养后的细胞存活率。结果成功制备了MgH_(2)复合明胶海绵,MgH_(2)微粒均匀分布在胶原海绵的表面且保持原有形貌。当MgH_(2)复合明胶海绵混合比例为1∶4时,在体外条件下具有潜在的抗变形链球菌性能。此外,MgH_(2)复合明胶海绵的细胞存活率为(72.02±3.89)%,与胶质银海绵组[(2.42±0.13)%]相比,差异具有统计学意义(P<0.01)。但是当MgH_(2)微粒浓度超过2 mg/mL时表现出较强的细胞毒性,细胞存活率为(1.11±0.17)%。结论MgH_(2)复合明胶海绵与胶质银明胶海绵相比具有较好的体外抗变形链球菌性能和细胞活力,有一定的临床应用潜能。

氨基化明胶海绵的制备及其止血性能研究

对明胶进行氨基化改性,同时用京尼平和单宁酸作为交联剂进行交联反应,然后冷冻干燥得到了氨基化明胶海绵。结果表明,该海绵具有丰富的孔状结构以及快速吸水能力,同时能够通过静电相互作用增强与血细胞间的结合能力,使其具有优异的止血性能,为快速止血材料的制备提供了新方法。

发泡剂用量对聚氨酯吸水海绵性能的影响

以水为单一发泡剂制备了系列聚氨酯吸水海绵,研究了发泡剂用量对聚氨酯吸水海绵性能的影响。结果表明,随着发泡剂用量的增加,聚氨酯吸水海绵的软段玻璃化温度逐渐升高;相对于100份多元醇,发泡剂用量为1.05~1.20份时,聚氨酯吸水海绵泡孔结构均匀、无明显缺陷,密度为55.6~62.4 kg/m^(3);发泡剂用量为1.20份时,聚氨酯吸水海绵拉伸强度和断裂伸长率均最大,分别为351 kPa和372%;聚氨酯吸水海绵具有良好的吸水性能,平衡吸水率均大于500%。

湿润烧伤膏对顽固性鼻出血手术患者术后出血、鼻腔通气及应激反应的影响

目的:探讨湿润烧伤膏联合鼻内镜下蝶腭动脉阻断术治疗顽固性鼻出血对患者出血量、鼻腔通气及应激反应的影响。方法:将97例顽固性鼻出血患者按照治疗方式不同分为对照组(n=49)和观察组(n=48)。对照组术中使用吸收性明胶海绵微填塞鼻腔;观察组术中使用涂抹湿润烧伤膏的明胶海绵微填塞鼻腔。比较两组临床疗效、出血和恢复情况、鼻腔通气情况、应激反应及并发症发生情况。结果:观察组治疗总有效率高于对照组,术后出血量少于对照组,鼻腔恢复通气时间短于对照组(P<0.05)。术后1 d、14 d、1个月,两组患者Lund-Kennedy评分、鼻吸气阻力值、鼻呼气阻力值、视觉模拟评分(VAS)、皮质醇(COR)水平均呈逐渐下降趋势,且观察组各时间点均低于对照组(P<0.05)。结论:湿润烧伤膏联合鼻内镜下蝶腭动脉阻断术治疗顽固性鼻出血可提高临床疗效,减少出血量,有效恢复鼻腔通气功能,并降低应激反应。

慢性鼻窦炎手术患者术腔填塞浸润布地奈德明胶海绵的临床疗效观察

目的:观察慢性鼻窦炎手术患者术腔填塞浸润布地奈德明胶海绵的临床疗效。方法:鼻窦炎患者共78例,均在2021年6月—2023年11月期间入贵州航天医院进行治疗。根据随机平行分组法划分为对比组与观察组,两组例数相同(n=39)。两组给予鼻内镜下鼻窦功能开放术治疗,对比组患者鼻腔填塞明胶海绵,观察组鼻腔填塞浸润布地奈德混悬液的明胶海绵。评析两组的症状评分、鼻黏液纤毛清除功能、炎性因子含量、治疗疗效、糖皮质激素并发症发生率。结果:症状评分,治疗后观察组低于对比组(P<0.05)。鼻黏液纤毛清除功能,治疗后观察组优于对比组(P<0.05)。炎性因子含量,治疗后观察组比对比组低(P<0.05)。治疗效果,治疗后观察组高于对比组(P<0.05)。糖皮质激素并发症发生率,治疗后两组对比差异无统计学意义(P>0.05)。结论:慢性鼻窦炎手术患者术腔填塞浸润布地奈德混悬液的明胶海绵,可以提高临床疗效,缓解其鼻塞症状,还可减轻炎性反应,改善鼻黏液纤毛清除功能,且安全性较佳。

胶原蛋白塞及胶质银止血明胶海绵在预防下颌阻生牙拔除后并发症中的效果分析

目的:比较胶原蛋白塞及胶质银止血明胶海绵在预防下颌阻生牙拔除后短期并发症中的临床效果。方法:选择双侧下颌第三磨牙阻生分类一致且均需要拔除的22例病人作为研究对象,采用分口设计,每位病人的左右下颌第三磨牙随机分为观察组和对照组。观察组拔牙创内填塞胶原蛋白塞,对照组拔牙创内填塞胶质银止血明胶海绵。比较2组术后30 min出血情况,术后第1、3天疼痛程度,术后第7天张口受限及干槽症发生情况。结果:观察组术后30 min出血率低于对照组,但差异无统计学意义(P>0.05)。观察组术后第1、3天疼痛VAS评分均低于对照组(P<0.05);2组术后第3天疼痛VAS评分均明显低于术后第1天(P<0.01)。观察组术后第7天张口受限发生率低于对照组,但差异无统计学意义(P>0.05)。2组均无干槽症发生。结论:胶原蛋白塞预防下颌阻生牙拔除后短期并发症的效果较好,值得推广。

博来霉素碘化油乳剂联合明胶海绵颗粒在肝血管瘤肝动脉栓塞中的临床研究

目的 探讨博来霉素碘化油乳剂联合明胶海绵颗粒在肝血管瘤肝动脉栓塞(transcatheter arterial embolization, TAE)中的临床效果及对并发症发生率的影响。方法 选取2015年8月至2021年12月我院介入医学科诊治的肝血管瘤患者80例为研究对象,所有患者均行TAE治疗,随机数字表法分为两组,每组各40例。对照组采用博来霉素碘化油乳剂治疗,观察组联合明胶海绵颗粒干预,两组治疗术后完成6个月门诊随访,比较两组手术有效率、手术指标、肝肾功能、总胆汁酸、血管瘤大小及术后并发症发生率。结果 观察组手术6个月后有效率为97.50%,高于对照组的85.00%(P<0.05);两组术后6个月瘤体直径均缩小;观察组瘤体直径低于对照组(P<0.05);两组术前及术后6个月Scr、BUN、ALT、AST水平差异无统计学意义(P>0.05);两组术后6个月TBA水平均低于术前(P<0.05),观察组术后6个月TBA水平低于对照组(P<0.05);两组围术期发热、术后感染、肝区疼痛、胆心反射及恶心呕吐发生率差异均无统计学意义(P>0.05)。结论 博来霉素碘化油乳剂联合明胶海绵颗粒用于肝血管瘤TAE患者中,能获得较高的有效率,手术创伤较小,对患者肝肾功能影响较小,能改善总胆汁酸水平,可缩小血管瘤,未增加术后并发症发生率,值得临床推广应用。

胶质银明胶海绵预防糖尿病患者拔牙术后并发症的临床效果

目的探究糖尿病患者拔牙后使用胶质银明胶海绵干预的效果。方法选取2021年1月—2023年10月咸宁市第一人民医院口腔科收治的200例糖尿病拔牙患者为研究对象,按拔牙后填充材料的不同分为对照组与观察组,每组100例。对照组使用常规医用明胶海绵,观察组使用胶质银明胶海绵。比较两组术后感染率、出血量和止血时间。结果观察组出血量和止血时间均少于对照组,差异有统计学意义(P均<0.05)。观察组的术后感染率为1.00%(1/100),低于对照组的10.00%(10/100),差异有统计学意义(χ^(2)=10.241,P<0.05)。结论糖尿病患者拔牙后使用胶质银明胶海绵可减少出血量,缩短止血时间,临床效果显著。

碘仿纱条与明胶海绵治疗鼻内镜术后鼻腔粘连的效果比较

目的比较碘仿纱条和明胶海绵治疗鼻内镜术后鼻腔粘连的效果。方法选择2018年1月至2022年12月行鼻内镜术后复查发现的73例(87侧)鼻腔粘连患者,随机将其分为对照组(36例,43侧)和治疗组(37例,44侧)。两组均行鼻腔粘连分解后,对照组选取明胶海绵作为隔离材料进行治疗,治疗组选取碘仿纱条作为隔离材料进行治疗。比较两组的治疗效果。结果两组患者的手术时间、出血量比较,差异无统计学意义(P>0.05);治疗组的视觉模拟量表(VAS)评分、治愈率及满意度高于对照组(P<0.05);术后3个月,两组的鼻腔鼻窦结局测试22条(SNOT-22)评分均降低,且治疗组低于对照组(P<0.05)。结论碘仿纱条和明胶海绵填塞术腔隔离治疗鼻腔粘连均可取得一定治疗效果,但前者的疗效和患者生活质量、满意度优于后者。

庆大霉素联合地塞米松明胶海绵在防治干槽症中的临床效果观察

目的探究庆大霉素联合地塞米松明胶海绵在防治干槽症中的临床效果观察。方法非随机选取2020年3月—2024年3月中山市东升医院收治的80例经下颌阻生智齿拔除手术患者为研究对象,根据治疗方法不同分为观察组和对照组,每组40例。对照组在牙拔除后牙槽窝内植入地塞米松明胶海绵,观察组植入庆大霉素联合地塞米松明胶海绵,比较两组患者患者牙齿恢复情况、术后疼痛情况及术后干槽症及其他并发症发生情况。结果术后第3、5、7天,两组的疼痛评分均低于术后第1天,且观察组评分低于对照组,差异有统计学意义(P均<0.05)。与植入前比较,两组牙槽窝愈合指数上升、牙龈指数下降,且观察组创口愈合时间较对照组更短,观察组整体恢复情况优于对照组,差异有统计学意义(P均<0.05)。观察组干槽症的发生率为10.00%(4/40),低于对照组的27.50%(11/40),差异有统计学意义(χ^(2)=4.021,P<0.05)。结论庆大霉素联合地塞米松明胶海绵能有效降低患者的疼痛程度,加快牙齿恢复进程,能有效降低干槽症的发生率。

曲安奈德封闭治疗联合吸收性明胶海绵填塞对肋软骨移植隆鼻术后供区疼痛的影响

目的 观察曲安奈德封闭治疗联合吸收性明胶海绵填塞供区在肋软骨采集术后的镇痛效果,为肋软骨采集患者术后镇痛提供参考。方法 选择2019年12月至2022年12月于深圳聚美博悦医疗美容门诊部接受肋软骨移植隆鼻手术女性患者116例,分为试验组57例和对照组59例,均切取右侧第7肋软骨。试验组患者采用曲安奈德封闭治疗联合吸收性明胶海绵填塞供区进行术后镇痛,对照组患者采用镇痛泵进行术后镇痛。用疼痛评分的方法评估患者术后6 h、1 d、3 d、5 d在静息状态和咳嗽时疼痛程度。结果116例患者胸部供区切口均一期愈合,试验组患者术后供区疼痛不明显,而对照组患者在术后供区疼痛明显,影响日常生活工作。两组患者术后6 h、1 d、3 d、5 d静息状态和咳嗽时的疼痛评分对比差异有统计学意义(P<0.05)。结论 采用曲安奈德封闭治疗联合吸收性明胶海绵填塞供区,可显著降低肋软骨移植隆鼻术后患者供区疼痛,提高对手术的整体评价,值得临床应用。

Overlay of a sponge soaked with ropivacaine and multisite infiltration analgesia result in faster recovery after laparoscopic hepatectomy

BACKGROUND Compared with traditional open surgery,laparoscopic surgery is preferred due to the advantages of less trauma,less pain,and faster recovery.Nevertheless,many patients still suffer from postoperative pain resulting from the surgical incision and associated tissue injury.Many researchers have reported methods to improve postoperative pain control,but there is not a simple and effective method that can be clinically adopted in a widespread manner.We designed this study to prove the hypothesis that application of ropivacaine in the port site and operative site in patients is an effective and convenient method which can decrease postoperative pain and accelerate recovery.AIM To evaluate the effects of ropivacaine on pain control after laparoscopic hepatectomy and its contribution to patient recovery.METHODS From May 2017 to November 2018,146 patients undergoing laparoscopic hepatectomy were randomized to receive infiltration of either 7.5 mg/mL ropivacaine around the trocar insertions,incision,and cutting surface of the liver(with a gelatin sponge soaked with ropivacaine)at the end of surgery(ropivacaine group),or normal saline(5 mL)at the same sites at the end of surgery(control group).The degree of pain,nausea,vomiting,heart rate(HR),and blood pressure were collected.The length of postoperative hospitalization,complications,and the levels of stress hormones were also compared between the two groups.RESULTS Compared with the control group,the ropivacaine group showed reduced postoperative pain at rest within 12 h(P<0.05),and pain on movement was reduced within 48 h.The levels of epinephrine,norepinephrine,and cortisol at 24 and 48 h,HR,blood pressure,and cumulative sufentanil consumption in the ropivacaine group were significantly lower than those in the control group(P<0.05).In the ropivacaine group,hospitalization after operation was shorter,but the difference was not statistically significant.There were no significant differences in postoperative nausea,vomiting,or other complications,including hydrothorax,ascites,peritonitis,flatulence,and venous thrombus(P>0.05),although fewer patients in the ropivacaine group experienced these situations.CONCLUSION Infiltration with ropivacaine in the abdominal wound and covering the cutting surface of the liver with a gelatin sponge soaked with ropivacaine significantly reduce postoperative pain and the consumption of sufentanil.

一种多孔可吸收明胶海绵止血材料应用优势比较

探讨可吸收性明胶海绵材料止血应用中效果。采用前瞻性病例对照研究方法,随机分为观察组(使用明胶海绵止血)和对照组(使用止血粉进行止血)。观察2种止血材料的术中使用效果,并分别比较2组的术中止血时间、术中出血量以及术后3 d引流量。结果表明,2组在使用止血材料后收缩压、舒张压均较使用前明显上升(P<0.05),使用后心率均明显下降(P<0.001);观察组术中止血时间、出血量和术后3 d引流量分别为(2.65±0.43)min、(105.55±20.53)mL和(66.38±20.07)mL;对照组术中止血时间、出血量和术后3 d引流量分别为(4.16±1.35)min、(210.65±25.85)mL和(151.76±35.33)mL,且组间比较差异均具有统计学意义(P<0.001)。2种止血材料均在成人股骨颈骨折内固定术中有着安全可靠的止血效果,相较止血粉,可吸收明胶海绵能够缩短术中止血时间,减少术中出血量和术后3 d引流量,其有着更好的止血效能。