中国组织工程研究

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

院前创伤急救止血敷料:优势与问题及应用前景

孙国飞,刘建恒,张里程,张立海,唐佩福   

  1. 解放军总医院骨科,北京市 100853
  • 收稿日期:2017-12-18 出版日期:2018-08-08 发布日期:2018-08-08
  • 通讯作者: 唐佩福,教授,主任医师,博士生导师,解放军总医院,北京市 100853
  • 作者简介:孙国飞,男,汉族,1987年生,解放军总医院在读硕士,主要从事创伤骨科研究。
  • 基金资助:

    面上项目(CWS14CO66):战创伤开放性损伤快速止血抑菌水凝胶的研发与应用研究;国家重点研发计划课题(AWS14C003):战创伤肢体软组织、骨缺损的修复研究;重大子项课题(2016YFC1102005):节段骨修复器械功能性动物实验、临床试验及临床技能研究

Hemostatic dressings for prehospital trauma care: strengths, problems and prospects

Sun Guo-fei, Liu Jian-heng, Zhang Li-cheng, Zhang Li-hai, Tang Pei-fu   

  1. Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China
  • Received:2017-12-18 Online:2018-08-08 Published:2018-08-08
  • Contact: Tang Pei-fu, Professor, Chief physician, Doctoral supervisor, Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China
  • About author:Sun Guo-fei, Master candidate, Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China
  • Supported by:

     the General Project, No. CWS14CO66; the National Key Research and Development Program of China, No. AWS14C003; the Major Sub-topics, No. 2016YFC1102005

摘要:

文章快速阅读:

 

文题释义:
止血敷料:按照作用机制进行分类:①浓缩因子类:这类止血剂通过快速吸收血液中水分进行止血,使红细胞和蛋白质成分浓缩,导致血凝块的形成,QuikClot、QuikClot ACS、TraumaDex和自我扩张止血聚合物都是这类;②黏附剂:通过粘连组织并物理封闭创伤出血口,HemCon和Celox是这类的主要样品;③补充促凝因子类:主要通过释放促凝因子到创伤位置达到凝血效果,干纤维蛋白胶敷料是这类敷料。
 
 
背景:在战场及偏远地区出现创伤性出血时,如果传统手段止血失败,使用止血敷料能够收到很好的止血效果,可作为临床上的辅助止血手段。
目的:通过分析目前止血敷料的特征、成分、不良反应和止血机制,旨在探索出一种用于院前及紧急环境中的安全有效止血敷料。
方法:检索PubMed、Embase和中国知网等数据库的相关文章,英文检索主题词为“hemorrhage,wounds,injuries,hemostasis”,关键词为“hemorrhage,blood loss,injuries,trauma,war,battle,hemostasis”;中文检索关键词为“止血,出血,止血剂,止血敷料,创伤,院前”。

结果与结论:按作用机制可将止血敷料分为浓缩凝血因子类、组织黏附剂类和补充促凝血因子类,这些止血敷料在止血效果和避免不良反应方面得到了很大改善,其中的几种止血敷料已获得了美国FDA的批准,并在战场上进行实践应用。目前尚未有理想的止血敷料,现有的止血敷料需要更多的研究来确定它们的止血效果及潜在的不良反应,发现新和更安全的止血敷料需要科研人员持续的努力。

ORCID: 0000-0002-9879-3787(孙国飞)

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程

关键词: 生物材料, 止血敷料, 出血, 凝血因子, 止血

Abstract:

BACKGROUND: When traumatic bleeding happens in the battlefield and remote areas, hemostatic dressings as an assisted hemostasis can provide a good hemostatic effect when the traditional method is failure to stop bleeding.

OBJECTIVE: To analyze the characteristics, components, side effects and hemostatic mechanism of hemostatic dressings, in order to explore a safe and effective hemostatic dressing for prehospital or emergent trauma care.
METHODS: PubMed, Embase and CNKI were retrieved using the MeSH words of “hemorrhage, wounds, injuries, hemostasis” in English and the keywords of “hemorrhage, blood loss, injuries, trauma, war, battle, hemostasis” in English and “hemostasis, bleeding, hemostatic agent, hemostatic dressing, wound, prehospital” in Chinese.

RESULTS AND CONCLUSION: Hemostatic dressings are classified into concentrated coagulation factors, tissue adhesives and supplementary procoagulant factors according to the mechanism of action. These dressings have been greatly improved in the hemostatic effect and avoiding side effects, several of which have won FDA approval and applied on the battlefield. Up to now, there is still no ideal hemostatic dressing. Further investigations are required to determine the hemostatic effect and potential adverse reactions of the existing hemostatic dressings. More efforts will be made to discover new and safe hemostatic dressings.

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程

Key words: Biological Dressings, Hemostasis, Hemorrhage, Blood Coagulation Factors, Tissue Engineering

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