Freire Dalmer Faria, Taha Murched Omar, Soares José Homero, Simões Manoel de Jesus, Fagundes Anna Luiza Negrini, Fagundes Djalma José
Surgery Residence, County Hospital, Campo Limpo, Sao Paulo, Brazil.
Acta Cir Bras. 2011 Jun;26(3):235-41. doi: 10.1590/s0102-86502011000300013.
To investigate the effectiveness of fibrin glue (laparoscopic via) into promote the hemostasis of a spleen injury on a heparinized porcine model.
Eighteen Landrace porcine were submitted to laparoscopic spleen injury and randomly distributed: GHA (heparin plus adhesive), GH (heparin without adhesive) and GS (Sham - without heparin or adhesive). Ten minutes before the surgical procedures a single IV dose (200UI/kg) of heparin sodium was administrated only to groups GHA and GH. In the GHA, adhesive was applied after the mechanical injury and recorded the time until the polymerization and clot formation.
No significant differences occurred among the groups (Fisher test) considering the weight and surgery time. The blood amount in the abdominal cavity on GH was significantly higher in comparison to the sham group and especially with the GHA (p<0.004). No significant differences were observed in the body temperature, heart rate, cardiac output, means arterial pressure, pulmonary artery pressure during the experiment. The activated partial thromboplastin time (APTT) was lower in the GHA in comparison to GH (p<0.003).
The fibrin biological adhesive applied by laparoscopy is effective for hemostasis of minor spleen injury in a porcine model under the effect of anticoagulant drug.
探讨纤维蛋白胶(经腹腔镜)在肝素化猪模型中促进脾损伤止血的有效性。
18头长白猪接受腹腔镜脾损伤手术,并随机分组:GHA组(肝素加粘合剂)、GH组(肝素不加粘合剂)和GS组(假手术组 - 不加肝素或粘合剂)。手术前10分钟,仅对GHA组和GH组静脉注射单剂量(200UI/kg)肝素钠。在GHA组中,机械损伤后应用粘合剂,并记录聚合和凝血形成的时间。
考虑体重和手术时间,各组间无显著差异(Fisher检验)。与假手术组相比,尤其是与GHA组相比,GH组腹腔内出血量显著更高(p<0.004)。实验期间,体温、心率、心输出量、平均动脉压、肺动脉压均未观察到显著差异。与GH组相比,GHA组活化部分凝血活酶时间(APTT)更低(p<0.003)。
在抗凝药物作用下,腹腔镜应用纤维蛋白生物粘合剂对猪模型中小的脾损伤止血有效。