摘要
目的评价伤口急救保护剂对猪肢体创伤创面的止血效果。方法采用切割伤法建立猪臀部凹陷性创面、侧面创面、膝关节处创面等三种模型共33个。伤后向每个创面喷洒伤口急救保护剂5～10s,在12h内观察动脉压、心率、止血时间、保护剂膜形成时间、保护剂膜厚度以及保护剂膜是否破裂而继发出血。分别在伤后即刻、0.5、1、2、3、4、6、8、12h取创面软组织及保护剂膜进行组织学、电镜检查。结果喷洒保护剂前后,每种模型的动脉压、心率无明显变化(P>0.05)。在喷洒保护剂时间、保护剂膜形成时间、止血时间以及保护剂膜厚度方面,凹陷性创面与侧面创面均无显著性差异(P>0.05);但这两种模型的喷洒保护剂时间、保护剂膜形成时间、止血时间与膝关节处创面以上指标之间却有明显差异(P<0.05)。三种模型的止血成功率均为100%,且均在喷保护剂后10s左右完全止血,在术后12h内没有继发出血。组织学及扫描和透射电镜检查显示喷洒保护剂后8h内保护剂膜下的软组织表现为轻度炎症反应,而12h后软组织内发现有较多炎细胞浸润,肌细胞出现线粒体肿胀、肌纤维部分断裂等损伤加重改变。保护剂膜还含有大量微孔。结论伤口急救保护剂止血速度快,止血效果满意,对创面软组织损伤轻,可透气,是一种良好的止血材料。
Objective To evaluate hemostatic effects of the wound aerosol dressing (WAD) for blood oozing wounds of swine limbs at first aid. Methods 33 models of blood oozing wounds were established by means of cutting in swine. They were of three kinds: concave and lateral wounds in swine hips and wounds across the knee joint.After injury, the WAD was sprayed to each wound model within 5 to 10 seconds. The main indexes, including average arterial blood pressure (AABP), heart rate (HR), hemostatic time (HT), the formation time (FT) and the thickness of WAD membrane shaped after spraying, were measured and the WAD membrane was observed to see if it would rupture within 12 hours postoperatively. Histological examination, TEM and SEM were performed in three concave wound models at 0.5, 1.0, 2.0, 3.0, 4.0, 6, 8, and 12h respectively. Results In each model, the AABP and HR were not different before and after spraying(P >0.05), neither were spraying time, HT and the thickness of the WAD membrane in the two kinds of concave wounds and lateral wounds (P >0.05). However, the above indexes of these two kinds of models were significantly different from those of the kind of wounds across the knee joint (P< 0.05). The rates of hemostatic success in all the three kinds of models were 100%. The HT was within 10 seconds after spraying and there was no succeeding bleeding within 12 hours. Histological examination, TEM and SEM showed that the soft tissue had mild inflammation response within 8 hours after spraying. After 12 hours there were some inflammatory cells in the wounds and a few broken muscle fibers in some muscular cells, which implied the wounds were suffering heavier lesion than before. The WAD membrane was also full of micropores. Conclusions The WAD has short HT and satisfactory hemostatic effects. Since the lesion made to the soft tissue of the wounds is mild, and the WAD membrane is gas permeable, the WAD is a kind of promising hemostatic dressing.
出处
《中华创伤骨科杂志》
CAS
CSCD
2003年第4期291-295,共5页
Chinese Journal of Orthopaedic Trauma
基金
全军"九五"医药卫生杰出中青年基金(98J004)
全军医学科研"十五"计划重点课题(02Z001)
