中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (25): 4739-4742.doi: 10.3969/j.issn.1673-8225.2011.25.044

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

再生氧化纤维素在严重骨质疏松体外循环手术胸骨止血中的作用

王  春，谷天祥，喻  磊，刘  波，卢春茂   

  1. 中国医科大学附属第一医院心脏外科，辽宁省沈阳市  110001
  • 收稿日期:2011-03-29 修回日期:2011-04-27 出版日期:2011-06-18 发布日期:2014-01-10
  • 通讯作者: 谷天祥，博士，教授，博士生导师，中国医科大学附属第一医院心脏外科，辽宁省沈阳市 110001 cmugtx@sina.com
  • 作者简介:王春☆，男，1979年生，山东省凌县人，汉族，2007年中国医科大学毕业，博士，主治医师，主要从事成人心血管疾病的外科治疗研究。 doctorchun@126.com
  • 基金资助:

    辽宁省教育厅基金项目(2004C050)《微创非体外循环不停跳冠状动脉搭桥手术临床及应用基础研究》；辽宁省科学技术计划项目(2006401013-2)《心脏静脉原位动脉化治疗冠心病弥漫性狭窄及全程闭塞的临床基础研究》。

Role of oxidized regenerated cellulose in the hemostasis of severe sternal osteoporosis during cardiopulmonary bypass

Wang Chun, Gu Tian-xiang, Yu Lei, Liu Bo, Lu Chun-mao   

  1. Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang  110001, Liaoning Province, China
  • Received:2011-03-29 Revised:2011-04-27 Online:2011-06-18 Published:2014-01-10
  • Contact: Gu Tian-xiang, Doctor, Professor, Doctoral supervisor, Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China cmugtx@sina.com
  • About author:Wang Chun☆, Doctor, Attending physician, Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China doctorchun@126.com
  • Supported by:

    the Funding of Liaoning Educational Bureau, No. 2004C050*; Liaoning Science and Technology Plan, No. 2006401013-2*

PDF

466

被引次数

19

摘要：

背景：严重骨质疏松患者正中开胸胸骨出血较多，尤其是体外循环下手术存在凝血功能障碍，更加重了术中及术后出血。
目的：与常规胸骨止血材料骨蜡对比，观察再生氧化纤维素在减少严重骨质疏松患者体外循环术后胸骨出血和预防胸骨切口感染中的作用。
方法：84例行正中开胸体外循环心脏手术的严重骨质疏松患者，随机分成2组。再生氧化纤维素组胸骨创面及骨髓腔内填充覆盖再生氧化纤维素，对照组常规应用医用骨蜡。记录两组术后1 d引流量、总引流量、拔引流管时间、总输血量、切口拆线时间、术后持续发热时间、平均住院时间及术后胸骨切口愈合情况，出院随访6个月。
结果与结论：两组术后1 d引流量、总引流量、拔引流管时间、总输血量及平均住院时间差异有显著性意义(P < 0.05)，再生氧化纤维素组更有优势。随访6个月中，再生氧化纤维素组未出现胸骨切口排出异物情况，对照组中有4例出现骨蜡排出。提示再生氧化纤维素可应用于严重骨质疏松患者体外循环后胸骨止血，近远期疗效确切，并在胸骨感染方面具有一定预防作用。

关键词: 再生氧化纤维素, 骨质疏松, 胸骨, 止血, 体外循环, 骨蜡

Abstract:

BACKGROUND: Patients with serious osteoporosis have more bleeding volume than those without osteoporosis during cardiac surgery with cardiopulmonary bypass.
OBJECTIVE: To study the efficacy of oxidized regenerated cellulose on reducing post-cardiopulmonary bypass sternal bleeding and preventing sternal infection in patients with severe osteoporosis．
METHODS: Eighty-four cases of severe osteoporosis undergoing open heart surgery were randomly divided into oxidized regenerated cellulose group and control group. The sternal wound and bone marrow cavity of the oxidized regenerated cellulose group was filled with oxidized regenerated cellulose, and that of the control group was with medical bone wax. Drainage volume at the first postoperative day, total drainage volume, time of draining tube, blood transfusion volume, suture removal time, duration of persistent fever, average hospital staying, postoperative sternal wound healing were recorded and observed, and all the patients were follow-up for 6 months.
RESULTS AND CONCLUSION: The comparison between two groups in the drainage volume at the first postoperative day, the total drainage volume, time of draining tube, the volume of blood transfusion and average hospital staying was significantly different (P < 0.05). During the follow-up, there was no case of discharging the foreign body from sternal wound in the oxidized regenerated cellulose group and 3 cases of discharging bone wax in the control group. Oxidized regenerated cellulose can be used in reducing bleeding and preventing sternal infection in patients with severe sternal osteoporosis after cardiopulmonary bypass. The short- and long-term efficacy is reliable.

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