摘要
背景:与传统止血方式相比,可吸收止血材料虽然价格较贵、认知度低,但是在一定的外科手术中具有较大的优势。目的:对可吸收止血材料的分类、临床使用情况、材料的安全性及其发展现状进行综述。方法:应用计算机检索PubMed数据库2003年1月至2020年3月的相关文献,检索词为"Absorbable Hemostatic Agents;Fibrin adhesives;Hemorrhage;Hemostatic dressings;Hemostats;Mechanical hemostats;Sealants";检索CNKI中国期刊全文数据库2004年1月至2020年3月的相关文献,检索词为"可吸收止血材料;止血材料;临床研究"。结果与结论:可吸收止血类材料主要通过加速创面的血液凝固过程而产生止血作用,常见的止血产品有纤维素类、淀粉等植物多糖、明胶/胶原蛋白、壳聚糖、纤维蛋白原类等。材料不同其止血机制也有差异,氧化再生纤维素、淀粉、明胶/胶原蛋白及壳聚糖类止血材料主要通过提供血小板活化和聚集作用形成血小板,纤维蛋白原类止血材料可以在凝血级联反应中参与形成纤维蛋白凝块。可吸收止血材料的使用依赖于医生经验或偏好,临床医生需要根据患者实际情况合理选择一个或多个止血材料组合。
BACKGROUND: Compared with traditional hemostatic methods, absorbable hemostatic materials are more expensive and have lower awareness, but they have greater advantages in certain surgical procedures.OBJECTIVE: To review the classification, clinical use, safety and development status of absorbable hemostatic materials.METHODS: The computer was used to search the PubMed database for relevant literature published from January 2003 to March 2020. The search terms were "Absorbable Hemostatic Agents;Fibrin adhesives;Hemorrhage;Hemostatic dressings;Hemostats;Mechanical hemostats;Sealants". China National Knowledge Infrastructure was retrieved for relevant literature published from January 2004 to March 2020. The search terms were "absorbable hemostatic material;hemostatic material;clinical research".RESULTS AND CONCLUSION: Absorbable hemostatic materials mainly produce hemostasis by accelerating the blood coagulation process of wounds. Common hemostatic products include cellulose, starch and other plant polysaccharides, gelatin/collagen, chitosan, and fibrinogen. Different materials have different hemostatic mechanisms. Oxidized regenerated cellulose, starch, gelatin/collagen and chitosan hemostatic materials mainly form platelets by providing platelet activation and aggregation. Fibrinogen hemostatic materials can be used in the coagulation cascade involved in the formation of fibrin clots. The use of absorbable hemostatic materials depends on the doctor’s experience or preference. Clinicians need to choose one or more hemostatic material combinations according to the actual situation of the patient.
作者
张爽
徐庆华
童琳
曹琛
叶红
Zhang Shuang;Xu Qinghua;Tong Lin;Cao Chen;Ye Hong(Anhui Academy of Medical Sciences,Hefei 230061,Anhui Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第10期1628-1634,共7页
Chinese Journal of Tissue Engineering Research
基金
安徽省卫计委科研课题(2018YK002),项目负责人:张爽。
关键词
材料
可吸收
止血
出血
凝血
纤维蛋白
止血材料
综述
materials
absorbable
hemostasis
bleeding
coagulation
fibrin
hemostatic material
review
