局部止血剂的临床研究新进展.pdf

中国药物应用与监测 2011年10月 第8卷 第5期 Chinese Journal of Drug Application and Monitoring, Vol.8, No.5, October 2011 ·药学进展· 局部止血剂的临床研究新进展 谢　霞，唐　杰 （解放军总医院超声科，北京 100853） [摘要] 创伤出血是诱发死亡的常见因素之一，及时有效地止血是挽救伤员生命的关键。随着局部止血剂的数量迅速增多， 有必要对国内外临床常用止血剂进行全面了解，使外科医生能够在恰当的时间成功选择正确的止血剂。目前国内外常用局 部止血剂有可吸收制剂、生物制剂、人工合成制剂。本文主要对外科常用局部止血剂的功效、作用机制、优劣势、使用方法 以及相关领域的新进展进行综述，为临床提供参考。 [关键词] 创伤；止血剂；局部应用；临床应用；进展 +.1 [文献标识码] A [文章编号] 1672 – 8157(2011)05 – 0311 – 04 [中图分类号] R973 Advance of topical hemostatic agents in the clinical study XIE Xia，TANG Jie ( Department of Ultrasound, PLA General Hospital, Beijing 100853, China ) Traumatic bleeding is one of the common factors inducing death, the key to save the wounded is timely and [ABSTRACT] effective hemostasis. With rapid increase of amount in topical hemostatic agents, it is necessary to comprehensively understand the common hemostatic agents used clinically both at home and abroad, so that the surgeons can successfully choose the right agent at the right time. At present, common hemostatic agents used both at home and abroad are subcategorized as absorbable agents, biologic agents, and synthetic agents. In this article, we mainly reviewed common topical hemostatic agents in surgery and their efficacy, mechanism of action, specific advantage and disadvantage, recommendations for use, and advances in related fields in order to provide reference in clinic. [KEY WORDS] Trauma; Hemostatic agents; Topical application; Clinical application; Advance 在过去的十年间，生物技术的进步使得局部止血 被氧化纤维素紧紧包裹的明胶海绵组成的管状止血 剂种类和数量爆发性增加。虽然它们并不能取代传 栓子来治疗 [2]。由于它比氧化再生纤维素或微原纤维 统的外科止血技术（如缝合、电外科等），但是当处理 胶原肿胀的更加明显，可以是它本身容积的两倍，易 多发挫裂伤出血、周围较脆弱结构（如神经）出血、胸 造成压迫性并发症，尤其是当靠近神经或在密闭狭小 腹实质脏器出血、针孔出血、腹腔镜或机器人手术中 的空间使用时[3]。明胶海绵可以在4 ~ 6周内降解吸 出血时，