中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (21): 3941-3944.doi: 10.3969/j.issn.1673-8225.2012.21.033

• 生物材料综述 biomaterial review • 上一篇    下一篇

医用生物可吸收止血材料的研究现状与临床应用★

张少锋1，洪加源2   

  1. 1福建中医药大学骨伤学院，福建省福州市   350108；2解放军第一七五医院全军骨科创伤中心，厦门大学附属东南医院，福建省漳州市   363000
  • 收稿日期:2011-11-12 修回日期:2012-01-09 出版日期:2012-05-20 发布日期:2012-05-20
  • 通讯作者: 洪加源，硕士生导师，副主任医师，解放军第一七五医院全军骨科创伤中心，厦门大学附属东南医院，福建省漳州市 363000 hongjy175@yahoo.com.cn
  • 作者简介:张少锋★，男，1983年生，甘肃省天水市人，汉族，福建中医药大学骨伤学院在读硕士，主要从事中医骨伤科临床研究。 zhangshaofeng017@163.com

Research status and clinical application of biomedical absorable hemostic materials

Zhang Shao-feng1, Hong Jia-yuan2   

  1. 1College of Orthopedics and Traumatology, Fujian University of Traditional Chinese Medicine, Fuzhou  350108, Fujian Province, China; 2Orthopedic Trauma Center, the 175 Hospital of Chinese PLA, Affiliated Southeast Hospital of Xiamen University, Zhangzhou  363000, Fujian Province, China
  • Received:2011-11-12 Revised:2012-01-09 Online:2012-05-20 Published:2012-05-20
  • Contact: Hong Jia-yuan, Master’s supervisor, Associate chief physician, Orthopedic Trauma Center, the 175 Hospital of Chinese PLA, Affiliated Southeast Hospital of Xiamen University, Zhangzhou 363000, Fujian Province, China hongjy175@yahoo.com.cn
  • About author:Zhang Shao-feng★, Studying for master’s degree, College of Orthopedics and Traumatology, Fujian University of Traditional Chinese Medicine, Fuzhou 350108, Fujian Province, China zhangshaofeng017@163.com

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摘要：

背景：目前市场已开发出多种不同组成和不同机制的止血材料，因其不同特性而应用各异。
目的：概述国内外临床常用医用可吸收止血材料，对其组成、止血机制及临床应用进行总结，指导临床医生更加合理有效地应用止血材料。
方法：应用计算机检索CNKI和PubMed数据库中2002-02/2011-05关于止血材料的文章，以“生物材料，止血材料，生物可吸收材料，止血效果，止血机制”或“biomaterial，hemostatic material，bioresorbable material，hemostatic effect，hemostatic mechanism”为中、英文关键词。纳入与生物可吸收止血材料及其应用相关的文章；排除重复研究的内容和与研究目的不相符的文献。
结果与结论：目前国内外主要应用的可吸收止血材料为纤维蛋白胶、氧化纤维素和氧化再生纤维素、α-氰基丙烯酸酯类组织胶、壳聚糖等。壳聚糖的止血性在于壳聚糖带有一定量的电荷，它的分子直接与创面上的红细胞发生交联反应形成血凝块，它的止血过程不依赖于机体凝血因子和血小板。α-氰基丙烯酸酯类黏合剂已应用于血管外科的中小管径血管吻合、神经外科的中硬脑膜修补、各类软组织修补、骨科中骨折的黏合等，并且成为介入栓塞治疗中的首选材料。在骨科领域纤维蛋白胶除了局部止血、防止粘连和渗漏外主要是作为缓释载体，骨材料支架而发挥作用。氧化纤维素和氧化再生纤维素已成功应用于神经外科、耳鼻喉科、肝胆外科等。不同的止血材料其止血机制和止血效果均不同，只有充分了解各种止血材料性能，才能合理、有效应用。
 

关键词: 止血材料, 生物材料, 生物可吸收, 止血效果, 止血机制

Abstract:

BACKGROUND: Now, various hemostasis materials are developed with different components and mechanisms. Due to their different characteristics, the applications are different.
OBJECTIVE: To review the commonly used clinical absorbable hemostatic materials at home and abroad, and to summarize the composition, hemostatic mechanism and clinical application for guiding clinicians to use them effectively.
METHODS: A computer-based search of CNKI and PubMed databases (2002-02/2011-05) were performed for articles related to hemostatic materials using the key words of “biological material, hemostatic material, bioresorbable material, hemostatic effect, hemostatic mechanism” in Chinese and English, respectively. Literatures on application of biomedical absorbable hemostatic materials were adopted, and others about duplicated study and contents inconsistent with the research purpose were excluded.
RESULTS AND CONCLUSION: Currently, fibrin glue, cellulose, xycellulose, α-cyanoacrylate tissue glue, chitosan and so on are adsorbable hemostasis materials in clinic. The hemostatic reason of chitosan is that the chitosan has some quantitative electric charge, which can directly occur cross linking reaction with the red blood cells on the wound surface to form blood clot, and the hemostasis process is independent of blood coagulation factor and platelet in vivo. Delightfully, α-cyanoacrylate tissue glues not only are used to cardiovascular surgery for small vascular anastomisis, to neurosurgery for repairing cerebral dura mater, to orthopedics for cohereing the fracture and repairing the soft tissues and so on, but also are the prefer material for intervention embolotherapy. While the fibrin glue can not only be local hemostasis, prevent conglutination and seepage, but also mainly be slow-release trager, bone material frame. However, different hemostasis materials have different hemostasis mechanisms and effects, so only to sufficiently comprehend the characteristic of different hemostasis materials can use them more reasonable and available.
 

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