Czerny M, Verrel F, Weber H, Müller N, Kircheis L, Lang W, Steckmeier B, Trubel W
Department of Surgery, University of Vienna, Austria.
J Cardiovasc Surg (Torino). 2000 Aug;41(4):553-7.
Bleeding from suture holes during vascular reconstruction, particularly when polytetrafluoroethylene (PTFE) prostheses are used, is still a problem which can lead to intraoperative delay and increased blood loss. The aim of this prospective, randomised, open, controlled multicentre study was to evaluate whether the use of a new local haemostyptic would reduce intraoperative blood loss and the time to haemostasis.
Thirty patients received a new haemostyptic (TachoComb H, Nycomed Pharma AG), whereas another 30 patients were treated with compresses. The vascular reconstructions were either anastomoses or patch angioplasties and were performed using PTFE vascular prostheses.
The mean time to haemostasis of suture hole bleeding in the haemostyptic group (326.0 sec) was significantly shorter compared to the control group (514.3 sec) (p=0.006). The median intraoperative blood loss was 24.5 g in the treatment group and 57.3 g in the control group (p=0.045).
It was shown that collagen patches coated with components of fibrin glue significantly reduce the time to haemostasis as well as blood loss at the operation site in patients undergoing vascular reconstruction with PTFE grafts.
血管重建过程中缝合孔出血,尤其是使用聚四氟乙烯(PTFE)人工血管时,仍是一个可导致手术延迟和失血增加的问题。这项前瞻性、随机、开放、对照多中心研究的目的是评估使用一种新型局部止血剂是否会减少术中失血和止血时间。
30例患者使用一种新型止血剂(TachoComb H,Nycomed Pharma AG),而另外30例患者使用敷料治疗。血管重建包括吻合术或补片血管成形术,使用PTFE血管假体进行。
止血剂组缝合孔出血的平均止血时间(326.0秒)显著短于对照组(514.3秒)(p = 0.006)。治疗组术中失血量中位数为24.5克,对照组为57.3克(p = 0.045)。
结果表明,在用PTFE移植物进行血管重建的患者中,涂有纤维蛋白胶成分的胶原蛋白贴片可显著缩短止血时间以及手术部位的失血量。