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本文引用的文献

1
Early experience with a novel gelatine-based sponge for local haemostasis in thyroid surgery.新型明胶海绵用于甲状腺手术局部止血的早期经验。
In Vivo. 2014 Mar-Apr;28(2):255-8.
2
Does adrenaline spraying over thyroidectomy area reduce bleeding?在甲状腺切除区域喷洒肾上腺素能减少出血吗?
Int J Clin Exp Med. 2014 Jan 15;7(1):274-9. eCollection 2014.
3
Effectiveness of an oxidized cellulose patch hemostatic agent in thyroid surgery: a prospective, randomized, controlled study.氧化纤维素贴片止血剂在甲状腺手术中的有效性:一项前瞻性、随机、对照研究。
J Am Coll Surg. 2013 Aug;217(2):221-5. doi: 10.1016/j.jamcollsurg.2013.03.022.
4
A review of risk factors and timing for postoperative hematoma after thyroidectomy: is outpatient thyroidectomy really safe?甲状腺切除术后血肿的危险因素和时间回顾:门诊甲状腺切除术真的安全吗?
World J Surg. 2012 Oct;36(10):2497-502. doi: 10.1007/s00268-012-1682-1.
5
Topical hemostatic agents in surgical practice.外科手术中的局部止血剂。
Transfus Apher Sci. 2011 Dec;45(3):305-11. doi: 10.1016/j.transci.2011.10.013. Epub 2011 Oct 29.
6
Achieving hemostasis with topical hemostats: making clinically and economically appropriate decisions in the surgical and trauma settings.使用局部止血剂实现止血:在手术和创伤环境中做出临床和经济上合适的决策。
AORN J. 2011 Nov;94(5):S1-20. doi: 10.1016/j.aorn.2011.09.018.
7
The efficacy of Ankaferd Blood Stopper for the management of bleeding following total thyroidectomy.安卡非德止血剂用于甲状腺全切除术后出血管理的疗效。
J Invest Surg. 2011;24(5):205-10. doi: 10.3109/08941939.2011.586092.
8
Postoperative adhesions after application of topical hemostatic agents: outcomes in a rat partial nephrectomy model.应用局部止血剂后发生的术后粘连:大鼠部分肾切除术模型的结果。
Urology. 2011 Oct;78(4):970.e9-14. doi: 10.1016/j.urology.2011.05.057. Epub 2011 Aug 5.
9
Utilization of thyroidectomy for benign disease in the United States: a 15-year population-based study.美国良性疾病甲状腺切除术的应用:一项基于人群的 15 年研究。
Am J Surg. 2011 May;201(5):570-4. doi: 10.1016/j.amjsurg.2010.12.006.
10
The use of a powdered polysaccharide hemostat (HemoStase) in live donor nephrectomies controls bleeding and reduces postoperative complications.在活体供肾肾切除术中使用一种多糖粉末止血剂(HemoStase)可控制出血并减少术后并发症。
Transplant Proc. 2011 Mar;43(2):424-6. doi: 10.1016/j.transproceed.2011.01.079.

微孔多糖微球产品在甲状腺手术中局部止血效果的评估:一项前瞻性随机对照研究。

Evaluation of local hemostatic effect of microporous polysaccharide hemospheres products in thyroid surgery: a prospective randomized controlled study.

作者信息

Kunduz Enver, Aysan Erhan, İdiz Ufuk Oğuz, Ersoy Yeliz Emine, Bektaşoğlu Hüseyin Kazım, Yığman Samet, Kundakcıoğlu Hacer

机构信息

Bezmialem Vakıf Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, İstanbul, Türkiye.

İstanbul Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye.

出版信息

Turk J Surg. 2019 Mar 1;35(1):49-53. doi: 10.5578/turkjsurg.4162. eCollection 2019 Mar.

DOI:10.5578/turkjsurg.4162
PMID:32550303
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6791685/
Abstract

OBJECTIVES

Bleeding is a rare and dangerous complication of thyroid surgery. One of the hemostatic agents used during surgery are microporous polysaccharide hemospheres (MPH) which are local hemostatic agents acquired from purified potato starch. The aim of this study was to evaluate the efficiency of two MPH, produced with different biotechniques, in decreasing hemorrhages and drainage following thyroidectomy.

MATERIAL AND METHODS

A statistical power analysis predicted that totally 20 patients per each group was needed within 95% confidential interval. Patients were randomized into 3 groups as control, Haemocer TM and Arista TM to be 20 patients in each group. Following bilateral total thyroidectomy, no additional procedures were performed in the first group, 5 g Haemocer was administered to the second group, 5 g Arista was administered to the third group into the operational field, and the operation was ended by placing a double-sided hemovac drain. At post-operative day one, drainage amount, calcium (Ca), phosphate (P) and parathyroid hormone (PTH) levels were noted.

RESULTS

No significant difference was noted between the groups for age, gender, removed tissue weight and malignant pathology rates. Also, no significant difference was noted between post-operative drainages and Ca, P, PTH levels of groups either. Hoarseness or hematoma were not observed in any patient.

CONCLUSION

MPHs are not proven in effectiveness in decreasing post-operative hemorrhages, which might be a key to avoiding unnecessary expenses.

摘要

目的

出血是甲状腺手术罕见且危险的并发症。手术中使用的止血剂之一是微孔多糖微球(MPH),它是一种从纯化马铃薯淀粉中提取的局部止血剂。本研究的目的是评估两种采用不同生物技术生产的MPH在减少甲状腺切除术后出血和引流方面的效果。

材料与方法

一项统计功效分析预测,在95%置信区间内每组总共需要20例患者。患者被随机分为3组,即对照组、Hemocer TM组和Arista TM组,每组20例。双侧全甲状腺切除术后,第一组不进行额外操作,第二组在术野中给予5 g Hemocer,第三组给予5 g Arista,然后放置双侧负压引流管结束手术。术后第1天,记录引流量、钙(Ca)、磷(P)和甲状旁腺激素(PTH)水平。

结果

各组在年龄、性别、切除组织重量和恶性病理发生率方面无显著差异。此外,各组术后引流以及Ca、P、PTH水平之间也无显著差异。所有患者均未出现声音嘶哑或血肿。

结论

MPH在减少术后出血方面的有效性尚未得到证实,这可能是避免不必要费用的关键。