Aysan Erhan, Basak Fatih, Kinaci Erdem, Tutuncu Hamdi
General Surgery Department, S.B. Istanbul Education and Research Hospital Istanbul, Turkey.
Hepatogastroenterology. 2007 Jun;54(76):1212-5.
BACKGROUND/AIMS: Hepatic bleeding following abdominal trauma is a serious problem. The implementation of various materials and techniques have been attempted to prevent bleeding but a standard method is indefinite.
Hepatic resection model was performed on rats. The efficacy of hemostasis with Polidocanol and Tetradecyl Sulfate has been evaluated through the comparison of perioperative bleeding amount and preoperative and postoperative hematocrit levels in the 24th hour. Also, histopathologic changes on parenchyma have been compared at a microscopic level.
Preoperative and postoperative hematocrit differences were 5.50 +/- 0.59 in Polidocanol group and 10 +/- 1.30 in Tetradecyl Sulfate group (MW: 2, p < 0.001). Perioperative bleeding amounts were: 1.50 +/- 0.20 mL in the Polidocanol group, 3.50 +/- 0.15 mL in the Tetradecyl Sulfate group and 7.50 +/- 0.41 mL in the Control Group. Upon comparison of perioperative bleeding amounts: the Control Group values were very high in comparison to the Polidocanol group (p < 0.001) and the Tetradecyl Sulfate group values were higher than those of the Polidocanol group (p < 0.05).
Local sclerosing agents, especially Polidocanol, appear to be an effective alternative method in hemostasis of hepatic bleeding.
背景/目的：腹部创伤后肝出血是一个严重问题。人们已尝试采用各种材料和技术来预防出血，但尚无标准方法。
在大鼠身上建立肝切除模型。通过比较围手术期出血量以及术后第24小时的术前和术后血细胞比容水平，评估了聚多卡醇和十四烷基硫酸钠的止血效果。此外，还在显微镜下比较了实质的组织病理学变化。
聚多卡醇组术前和术后血细胞比容差异为5.50±0.59，十四烷基硫酸钠组为10±1.30（MW：2，p<0.001）。围手术期出血量分别为：聚多卡醇组1.50±0.20 mL，十四烷基硫酸钠组3.50±0.15 mL，对照组7.50±0.41 mL。比较围手术期出血量：对照组的值与聚多卡醇组相比非常高（p<0.001），十四烷基硫酸钠组的值高于聚多卡醇组（p<0.05）。
局部硬化剂，尤其是聚多卡醇，似乎是肝出血止血的一种有效替代方法。
