目的制备可吸收交联微孔止血粉,观察其对肝脏、肾脏和股动脉出血的止血效果并探讨其止血机制。方法取成年健康新西兰兔30只,雌雄不限,体质量20002250g,随机分成A、B、C组(A组为肝脏出血模型,B组为肾脏出血模型,C组为股动脉出血模型),每组均根据切口再随机分成可吸收交联微孔止血粉实验组(1组)和Arista^TM止血粉对照组(2组),每组5只,按随机化分组原则在出血创面喷洒1g止血材料进行止血,观察止血情况并记录出血量和止血时间。止血成功后取创伤周围组织进行H-E染色,观察组织学变化。结果A1、A2组出血量分别为(1.02±0.10)g和(1.03±0.09)g,止血时间分别为(92.6士5.16)s和(95.6±5.31)s,两组差异无统计学意义(P〉0.05);B1、B2组出血量分别为(0.92±O.09)g和(O.94±0.08)g,止血时间分别为(87.5±7.48)S和(88.8土6.54)S,两组差异无统计学意义(P〉0.05);C组股动脉出血模型止血失败。创伤周围组织切片H-E染色显示红细胞大量聚集,无灼伤迹象。结论可吸收交联微孔止血粉对于实质性脏器能达到与Arista^TM止血粉相似的止血效果,但不适用于压力较高的知名动脉出血的止血。
Objective To prepare an absorbable crosslinked microporous hemostatic starch(ACMHS), to observe its hemostasis effect in the liver, kidney and femoral artery, and to discuss the hemostasis mechanism. Methods Thirty adult healthy New Zealand rabbits of either sex, weighing 2,000-2,250 g, were equally randomized into 3 groups., liver bleeding group (group A), kidney bleeding group (group B) and femoral artery bleeding group (group C). Each group was further divided into a test group and a control group randomly (n=5) according to different hemostatic powders;ACMHS was used in the test group(group A1, B1, C1), and AristaTM was used in the control group (group A2, B2, C2). The bleeding amount and bleeding time were accurately recorded. The pathological changes at incision and in the surrounding tissues of the liver, kidney and femoral artery were observed by hematoxylin-eosin staining after test. Results All the bleeding amounts of group A1 and A2 were (1. 024±0.10) g and (1.03±0.09) g, and the bleeding time periods of group A1 and A2 were (92.64±5.16) s and (95.6±5.31) s, respectively (P〉0.05). All the bleeding amounts of group B1 and B2 were (0. 92±0.09) g and (0. 94± 0.08) g, and the bleeding time periods of group B1 and B2 were (87.5±7.48) s and (88.8±6.54) s, respectively (P〉0.05). All the hemostatic efforts failed in group C. Hematoxylin-eosin staining showed accumulation of red blood cells at the incisionand in surrounding tissues of the liver and kidney in group A and group B, without evidence of burn. Conclusion ACMHS has the same hemostatic function as AristaTM in parenchymatous organ injury, but it is not suitable for bleeding of femoral artery injury with high pressure.