[目的]观察评价可吸收明胶海绵棒在椎弓根置钉过程中的止血效果。[方法]2017年10月~2018年6月,48例胸腰椎骨折即将行后路手术的患者纳入本研究,采用随机数字表法分为明胶海绵组和骨蜡组。明胶海绵组共23例,置钉过程中应用明胶海绵棒填...[目的]观察评价可吸收明胶海绵棒在椎弓根置钉过程中的止血效果。[方法]2017年10月~2018年6月,48例胸腰椎骨折即将行后路手术的患者纳入本研究,采用随机数字表法分为明胶海绵组和骨蜡组。明胶海绵组共23例,置钉过程中应用明胶海绵棒填塞至椎弓根孔道止血;骨蜡组共25例,在透视定位时应用骨蜡封闭椎弓根孔道。记录置钉情况;记录术中出血量、自体血回输量、置钉过程中的出血量、输血量;检测术前和术后5 d RBC、HB和HCT。[结果]两组在置钉总数、伤椎置钉数、伤椎位置各椎置钉数量的差异均无统计学意义(P>0.05)。术后两组各出现1例小腿肌间静脉血栓,抗凝治疗后于复查时消失。术后两组均无明胶海绵或骨蜡导致的不良反应。两组在术中出血量、术中自体血回收量、输血量的差异无统计学意义(P>0.05),但明胶海绵组上述指标均小于骨蜡组。每钉置入过程中明胶海绵组的出血量显著少于骨蜡组,差异有统计学意义(P<0.05)。两组术后5 d的RBC、HB和HCT均较术前显著减少,两时间点间差异均有统计学意义(P<0.05)。术前两组在RBC、HB和HCT的差异均无统计学意义(P>0.05),术后5 d两组在RBC、HB和HCT的差异亦均无统计学意义(P>0.05)。[结论]应用明胶海绵棒填塞椎弓根孔道止血可显著减少安置椎弓根螺钉过程中的出血,是一种简单、安全、有效的脊柱外科术中止血方法。展开更多
This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a...This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.展开更多
文摘[目的]观察评价可吸收明胶海绵棒在椎弓根置钉过程中的止血效果。[方法]2017年10月~2018年6月,48例胸腰椎骨折即将行后路手术的患者纳入本研究,采用随机数字表法分为明胶海绵组和骨蜡组。明胶海绵组共23例,置钉过程中应用明胶海绵棒填塞至椎弓根孔道止血;骨蜡组共25例,在透视定位时应用骨蜡封闭椎弓根孔道。记录置钉情况;记录术中出血量、自体血回输量、置钉过程中的出血量、输血量;检测术前和术后5 d RBC、HB和HCT。[结果]两组在置钉总数、伤椎置钉数、伤椎位置各椎置钉数量的差异均无统计学意义(P>0.05)。术后两组各出现1例小腿肌间静脉血栓,抗凝治疗后于复查时消失。术后两组均无明胶海绵或骨蜡导致的不良反应。两组在术中出血量、术中自体血回收量、输血量的差异无统计学意义(P>0.05),但明胶海绵组上述指标均小于骨蜡组。每钉置入过程中明胶海绵组的出血量显著少于骨蜡组,差异有统计学意义(P<0.05)。两组术后5 d的RBC、HB和HCT均较术前显著减少,两时间点间差异均有统计学意义(P<0.05)。术前两组在RBC、HB和HCT的差异均无统计学意义(P>0.05),术后5 d两组在RBC、HB和HCT的差异亦均无统计学意义(P>0.05)。[结论]应用明胶海绵棒填塞椎弓根孔道止血可显著减少安置椎弓根螺钉过程中的出血,是一种简单、安全、有效的脊柱外科术中止血方法。
文摘This study aims to develop collagen-based hemostatic materials. The sheet-shaped collagen sponge was manufactured by freeze-vacuum drying the aqueous solution of collagen (Col) and heat-denatured collagen (Col’) at a composition ratio of 2/1. The both sides or one side of sponge was treated with ultraviolet (UV) irradiation for 15 minutes to introduce intermolecular crosslinks between collagen molecules. The elution behavior of collagen sponge was investigated by immersing the sponge in water for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge showed very slow elution properties. On the other hand, the single-sided UV-irradiated sponge showed initially fast elution and subsequent very slow elution properties. Such initially fast elution of collagen molecules from the surface without UV-irradiation allows an adhesion of collagen sponge to the wound surface and results in hemostatic effect. In addition, the water absorption and retention properties of sponge were investigated by placing the hydrated sponge on a mesh for a predetermined time and then by measuring the weight change. The double-sided UV-irradiated sponge absorbed 81 times more water than own weight and showed a value of 45 times even after 7 days. The single-sided UV-irradiated sponge absorbed 80 times more water than own weight and showed a value of 39 times even after 7 days. The sponge with high water absorption and retention properties allows a wound healing effect because such sponge can absorb large amounts of blood plasma and exudates containing various cell growth factors. The double-sided UV-irradiated sponge is a good candidate for the wound dressing. On the other hand, the single-sided UV-irradiated sponge is a good candidate for the hemostatic material.
