Stiller-Timor L, Goldbart A D, Segal N, Amash A, Huleihel M, Leiberman A, Tal A, Holcberg G, Puterman M
Department of Otolaryngology-Head & Neck Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Int J Pediatr Otorhinolaryngol. 2012 Mar;76(3):419-22. doi: 10.1016/j.ijporl.2012.01.001. Epub 2012 Jan 23.
Fibrin glue is used as a haemostatic agent or as a sealant. The aim of this study is to objectively evaluate the efficacy of the use of fibrin glue Quixil - a human surgical sealer - in tonsillectomy, for the reduction of post-operative inflammatory response.
A prospective randomized single-blind study.
The study was performed on 40 consecutive patients undergoing adenotonsillectomy (T&A). Patients were randomly assigned to one of two sub-groups: a study group and a control group. The tonsillar beds of patients in the study group were coated with fibrin glue (Quixil, OMRIX biopharmaceuticals) at the end of the operation; the patients in the control group were treated for hemostasis without the use of fibrin glue. Complete blood counts and circulating pro-inflammatory cytokines (assayed by specific immunoassay - ELISA) were assessed in samples drawn pre- and 16 h post-tonsillectomy.
Forty patients (aged 5.8 ± 2.4 years) were consecutively enrolled; 45% (18) of the patients were treated with fibrin glue, 55% (22) were not. Compared to controls, Quixil-treated patients demonstrated a reduction in post-tonsillectomy circulating leukocytes (29.2% vs. 45.4%, p<0.05), neutrophiles (28.3% vs. 42.1%, p<0.05), IL-6 (+1% vs. +42%, p<0.05), and TNF-alpha (+8% vs. +26%, p<0.05.
Intra-operative fibrin glue therapy is associated with decreased immediate inflammatory response following T&A. Further studies are warranted to assess long-term outcome.
1B.
纤维蛋白胶用作止血剂或密封剂。本研究的目的是客观评估使用纤维蛋白胶Quixil（一种人用手术密封剂）在扁桃体切除术中减少术后炎症反应的疗效。
一项前瞻性随机单盲研究。
对40例连续接受腺样体扁桃体切除术（T&A）的患者进行研究。患者被随机分为两个亚组：研究组和对照组。研究组患者在手术结束时扁桃体床用纤维蛋白胶（Quixil，OMRIX生物制药公司）覆盖；对照组患者不使用纤维蛋白胶进行止血治疗。在扁桃体切除术前和术后16小时采集的样本中评估全血细胞计数和循环促炎细胞因子（通过特异性免疫测定 - ELISA测定）。
连续纳入40例患者（年龄5.8±2.4岁）；45%（18例）患者接受纤维蛋白胶治疗，55%（22例）未接受。与对照组相比，接受Quixil治疗的患者扁桃体切除术后循环白细胞减少（29.2%对45.4%，p<0.05），中性粒细胞减少（28.3%对42.1%，p<0.05），IL-6升高幅度减小（+1%对+42%，p<0.05），TNF-α升高幅度减小（+8%对+26%，p<0.05）。
术中纤维蛋白胶治疗与扁桃体切除术后即刻炎症反应减轻相关。有必要进一步研究评估长期结果。
1B。
