Herter T, Windmann D
Klinik und Poliklinik für Neurochirurgie, Westfälischen Wilhelms-Universität Münster.
Handchir Mikrochir Plast Chir. 1992 Nov;24(6):319-23.
Although fibrin glue has been used in several areas of surgery with increasing success, it has not become fully established in nerve coaptation. Initially, significant advantages were expected, however, as the fibrin clot dissolved prematurely, gapping occurred and antifibrinolytic substances had to be added to the glue. Following this procedure, fibrosis occurred frequently. This remains a problem. Therefore, the dosage dependent fibrosis-inducing effect of thrombin was investigated in an animal experimental study. Thrombin demonstrates a fibrosis-promoting effect and we therefore recommend 1-1.5 NIH thrombin/ml glue, as lower concentrations increase the clotting time.
尽管纤维蛋白胶已在多个外科领域得到越来越广泛的应用并取得了一定成功,但在神经吻合术中尚未完全确立其地位。起初,人们预期它会有显著优势,然而,由于纤维蛋白凝块过早溶解,出现了缝隙,不得不向胶中添加抗纤溶物质。采用此方法后,纤维化频繁发生。这仍是一个问题。因此,在一项动物实验研究中对凝血酶的剂量依赖性促纤维化作用进行了研究。凝血酶具有促进纤维化的作用,因此我们建议每毫升胶使用1 - 1.5 NIH单位的凝血酶,因为较低浓度会延长凝血时间。