摘要
目的建立猪腹股沟区贯通伤合并股动脉出血模型,验证链式止血装置在该模型中的止血效果。方法选取成年巴马小型猪8只,采用腹股沟区肌肉离断和股动脉6 mm打孔法建立腹股沟区贯通伤合并股动脉出血模型。将建模后的8只小型猪随机均分为两组,实验组应用链式止血装置(由一次性推送管和压缩聚乙烯醇树脂海绵组成)止血,采用推注注射方式将链式止血材料注入伤口内,膨胀后压迫止血;对照组采用普通纱布以叠瓦式填塞入伤口止血。3 h后取出两组止血材料,观察两组动物存活情况、建模出血量、止血开始到止血结束的出血量、止血时间、总出血量、材料取出时间、伤口底部肌肉组织及近端股动脉病理组织学表现。结果成功建立腹股沟区贯通伤合并股动脉出血模型,两组动物全部存活。实验组止血时间短于对照组[(44.3±7.0)s vs.(380.3±23.2)s,P<0.001],总出血量少于对照组[(331.0±11.9)ml vs.(712.8±72.8)ml,P<0.001],但两组建模出血量[(242.0±10.3)ml vs.(242.5±6.6)ml,P>0.05]和止血材料取出时间[(26.3±6.4)s vs.(26.5±5.1)s,P>0.05]差异无统计学意义。两组肌肉组织均未见明显断裂及坏死,两组近心端血管组织内膜、中膜、外膜均较为完整,未见明显坏死。结论巴马小型猪腹股沟区贯通伤合并股动脉出血模型具有可靠、有效、重复性高的优点,可用于不同止血材料的应用研究。链式止血装置在止血时间和出血量方面明显优于普通纱布,且不会对组织造成损伤,是一种良好的止血装置。
Objective To establish a pig model of inguinal penetrating injury combined with femoral artery hemorrhage,and verify the hemostatic effect of chain-based sponge for the model.Methods The model of inguinal penetrating injury complicated with femoral artery hemorrhage was established with 8 adult Bama mini pigs by muscle transection in inguinal region and perforation of 6 mm femoral artery.The 8 model pigs were randomly and equally divided into two groups.Chain-based hemostatic device(consisted of a disposable push pipe and a compressed polyvinyl alcohol resin sponge)was used for hemostasis of pigs in experimental group.The chain-based sponge were injected into the wound,and the bleeding was compressed after expansion.While in the control group,ordinary gauze was used to fill the wound in a shingle way to stop bleeding.After 3 hours,the hemostatic materials in the two groups were taken out,the survival status of animals in the two groups,the amount of modeled bleeding,the bleeding amount from the start to the end of hemostasis,the time of hemostasis,the total bleeding amount,the time of hemostatic materials removal,and the histopathological findings of muscle tissue at the bottom of the wound and the proximal femoral artery were observed in the two groups.Results The model of inguinal penetrating injury combined with femoral artery hemorrhage was successfully established.All animals in the two groups survived.The hemostasis time was shorter in experimental group than that in control group[(44.3±7.0)s vs.(380.3±23.2)s,P<0.001];After treatment,the total bleeding amount was less in experimental group than that in control group[(331.0±11.9)ml vs.(712.8±72.8)ml,P<0.001].There was no statistical difference in the amount of modeled bleeding[(242.0±10.3)ml vs.(242.5±6.6)ml,P>0.05]and the time of hemostatic materials removal between the two groups[(26.3±6.4)s vs.(26.5±5.1)s,P>0.05].No obvious fracture or necrosis was observed in the muscle tissue of the two groups.The endometrial,medial and outer membranes of the proximal vascular tissue were relatively complete and no obvious necrosis was observed.Conclusions The Bama mini pig model of inguinal penetrating injury combined with femoral artery hemorrhage has the advantages of reliability,efficiency and high repeatability,and can be used for the application research of different hemostatic materials.The chain-based sponge is superior to ordinary gauze in hemostatic time and blood loss,and cause no damage to tissue,so is a good hemostatic device.
作者
杨为锦
周友栩
宋俊川
朱越文
杨劲
肖春红
江传燊
吴伟航
林晨
王瑜
YANG Wei-jin;ZHOU You-xu;SONG Jun-chuan;ZHU Yue-wen;YANG Jin;XIAO Chun-hong;JIANG Chuan-shen;WU Wei-hang;LIN Chen;WANG Yu(The 900th Hospital of Chinese PLA Joint Service Support Force/Clinical Institute of Fuzhou General Hospital,Fujian Medical University/Dongfang Hospital,Xiamen University,Xiamen,Fujian 350025,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2019年第12期1007-1012,共6页
Medical Journal of Chinese People's Liberation Army
基金
国家科技重大专项(2018ZX)
全军医学科技重点项目(CNJ15J004,CNJ16J005)
解放军联勤保障部队第900医院院内课题(2015J01)
军事后勤科研项目(CNJ15J003,CLB18J035)~~
