Ma Litai, Dai Lijuan, Yang Yi, Liu Hao
Department of Orthopedics, West China Hospital, Sichuan University.
College of Computer Science, Sichuan University, Sichuan Province, P. R. China.
Medicine (Baltimore). 2018 Dec;97(49):e13511. doi: 10.1097/MD.0000000000013511.
To compare the hemostatic effect of hematostatic agent Surgiflo and absorbable gelatin sponge (AGS) in posterior lumbar surgery.
A total of 60 cases were recruited during August 2016 and June 2017 according to the inclusion and exclusion criteria. Patients were randomly allocated to the Surgiflo Haemostatic Matrix (SHM) group or the AGS group (AGS) by computer-generated randomization codes. The success rates of hemostasis for 3 minutes and 5 minutes, the time of operation, the amount of intraoperative bleeding, the volume of autogenously blood transfusion, the amount of blood during hemostasis, the amount of blood transfusion, and BP, RBC, HCT, HB of preoperative, 2 to 3 days, and 5 to 7 days following operation were recorded to compare. Daily drainage and all adverse events after operation were also compared.
All the patients were followed up for at least 1 month. The RBC and HCT of the AGS group before operation were lower than those in the control group (P = .039, P = .029), but there was no difference after operation (P >.05). In the control group, 19 cases were successfully hemostatic in 3 minutes, 4 cases were successful in 5 minutes, and 7 cases were combined with hemostasis. In the SHM group, it was 22, 3, and 5 cases respectively. There was significant difference in blood loss during hemostatic process between the 2 groups (P <.001). There was no difference in the amount of blood loss and autologous blood transfusion between the 2 groups, and there was no difference in the operation time between the 2 groups. In the AGS group, allogeneic blood was infused in 1 case during operation, and no allogeneic blood was infused in the other patients. The drainage volume on the 1st day and the 2nd to 4th day after operation in the AGS group was less than that in the control group (P = .015, P = .010).
Compared with AGS, SHM could decrease the blood loss during hemostatic process and the postoperative drainage volume in posterior operation of lumbar degenerative disease. SHM is a safe and effective hemostatic agent in lumbar posterior surgery.
比较止血剂速即纱（Surgiflo）与可吸收明胶海绵（AGS）在腰椎后路手术中的止血效果。
根据纳入和排除标准，于2016年8月至2017年6月共招募60例患者。通过计算机生成的随机编码将患者随机分为速即纱止血基质（SHM）组或AGS组。记录3分钟和5分钟时的止血成功率、手术时间、术中出血量、自体输血量、止血过程中的出血量、输血量以及术前、术后2至3天和5至7天的血压、红细胞（RBC）、血细胞比容（HCT）、血红蛋白（HB），进行比较。还比较术后每日引流量和所有不良事件。
所有患者均随访至少1个月。AGS组术前的RBC和HCT低于对照组（P = 0.039，P = 0.029），但术后无差异（P > 0.05）。对照组3分钟内成功止血19例，5分钟内成功4例，联合止血7例。SHM组分别为22例、3例和5例。两组止血过程中的失血量有显著差异（P < 0.001）。两组间失血量和自体输血量无差异，两组手术时间也无差异。AGS组术中1例输注异体血，其他患者未输注异体血。AGS组术后第1天及术后第2至4天的引流量少于对照组（P = 0.015，P = 0.010）。
与AGS相比，SHM可减少腰椎退行性疾病后路手术止血过程中的失血量和术后引流量。SHM是腰椎后路手术中一种安全有效的止血剂。
