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豚鼠血管损伤止血中聚氨酯与氰基丙烯酸酯的比较。

Comparison of polyurethane with cyanoacrylate in hemostasis of vascular injury in guinea pigs.

作者信息

Kubrusly Luiz Fernando, Formighieri Marina Simões, Lago José Vitor Martins, Graça Yorgos Luiz Santos de Salles, Sobral Ana Cristina Lira, Lago Marianna Martins

机构信息

Instituto do Coração de Curitiba, Curitiba, PR, Brazil.

Faculdade Evangélica do Paraná, Curitiba, PR, Brazil.

出版信息

Rev Bras Cir Cardiovasc. 2015 Jan-Mar;30(1):119-26. doi: 10.5935/1678-9741.20140125.

Abstract

OBJECTIVE

To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate.

METHODS

Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent.

RESULTS

Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001).

CONCLUSION

Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.

摘要

目的

评估蓖麻油衍生的聚氨酯作为止血剂在腹主动脉损伤后的止血性能及组织反应,并将其与2-辛基氰基丙烯酸酯进行比较。

方法

将24只豚鼠随机分为三组,每组8只动物(I组、II组和III组)。解剖肾下腹主动脉,在血管穿刺部位的近端和远端进行钳夹。I组(对照组)采用指压止血;II组(聚氨酯组)应用蓖麻油衍生的聚氨酯;III组(氰基丙烯酸酯组)使用2-辛基氰基丙烯酸酯。II组根据止血剂的制备时间细分为IIA组和IIB组。

结果

IIA组、IIB组和III组的平均失血量分别为0.002克(g)、0.008 g和0.170 g,标准差分别为0.005 g、0.005 g和0.424 g(P = 0.069)。氰基丙烯酸酯的干燥时间平均为81.5秒(s)(标准差:51.5秒),聚氨酯B的干燥时间为126.1 s(标准差:23.0 s)(P = 0.046)。然而,氰基丙烯酸酯的干燥速度有比聚氨酯A更慢的趋势(P = 0.069)(平均值:40.5 s;标准差:8.6 s)。此外,聚氨酯A的干燥时间比聚氨酯B短(P = 0.003),IIA组平均值为40.5 s(标准差:8.6 s)。在III组中,100%的动物出现轻度/重度纤维化,而在II组中只有12.5%表现出这种程度的纤维化(P = 0.001)。

结论

蓖麻油衍生的聚氨酯表现出与2-辛基氰基丙烯酸酯相似的止血性能。与氰基丙烯酸酯相比,聚氨酯引起的血管周围组织反应更小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8da1/4389526/930ac30ae8b0/rbccv-30-01-0119-g01.jpg

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