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改良快速部署止血绷带可止住患有严重内脏损伤的凝血障碍患者的出血。

Modified rapid deployment hemostat bandage terminates bleeding in coagulopathic patients with severe visceral injuries.

作者信息

King David R, Cohn Stephen M, Proctor Kenneth G

机构信息

Dewitt-Daughtry Family Department of Surgery, Division of Trauma, Trauma and Surgical Critical Care Research Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.

出版信息

J Trauma. 2004 Oct;57(4):756-9. doi: 10.1097/01.ta.0000147501.64610.afs.

Abstract

BACKGROUND

We recently reported that a new dressing, the Modified Rapid Deployment Hemostat (MRDH) controlled bleeding in hypothermic coagulopathic swine after traumatic liver avulsion. The purpose of this study was to evaluate the MRDH in coagulopathic trauma patients undergoing abbreviated laparotomy.

METHODS

A prospective, observational clinical trial of the MRDH dressing was performed at our Level One Trauma Center in patients with high-grade visceral injuries with coagulopathy who failed conventional therapy and required packing. Attending surgeons graded the injury and the adequacy of hemostasis following application of the dressing. Patients were followed until discharge or death.

RESULTS

Ten patients were enrolled: nine severe hepatic injuries, and one major abdominal vascular injury. All patients were hypothermic, acidotic, and clinically coagulopathic. Intraoperative hemostasis was immediately obtained after MRDH placement in all cases except one. There was one death.

CONCLUSION

The Modified Rapid Deployment Hemostat terminates bleeding from severe visceral injuries in coagulopathic patients undergoing abbreviated laparotomy.

摘要

背景

我们最近报道了一种新型敷料,改良快速部署止血器(MRDH),它能控制外伤性肝撕裂伤后低温凝血障碍猪的出血。本研究的目的是评估MRDH在接受简化剖腹手术的凝血障碍创伤患者中的效果。

方法

在我们的一级创伤中心,对患有高级别内脏损伤且伴有凝血障碍、常规治疗无效且需要填塞的患者进行了一项关于MRDH敷料的前瞻性观察性临床试验。主治外科医生对损伤情况以及敷料应用后的止血充分程度进行分级。对患者进行随访直至出院或死亡。

结果

共纳入10例患者:9例严重肝损伤,1例腹部大血管损伤。所有患者均体温过低、酸中毒且临床上存在凝血障碍。除1例病例外,所有病例在放置MRDH后术中立即实现止血。有1例死亡。

结论

改良快速部署止血器可使接受简化剖腹手术的凝血障碍患者严重内脏损伤引起的出血停止。

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