Klinika Chirurgii Kolorektalnej, Ogólnej i Onkologicznej Centrum Medycznego Kształcenia Podyplomowego, Szpital Bielański, Warszawa.
Pol Przegl Chir. 2021 Feb 26;93(1):49-54. doi: 10.5604/01.3001.0014.7914.
Haemostatic materials such as: gelatine sponges, oxygenated cellulose meshes, tissue sealants, collagen matrices with human thrombin and fibrinogen are gaining on popularity in gastrointestinal surgery, especially in colorectal surgery. We searched for available scientific publications in the Pubmed and Cochrane database on the use of individual hemostatic materials in the field of gastrointestinal surgery. The analysis focused on the assessment of the safety of the use of individual materials in terms of the rate of bleeding complications and the rate of anastomotic leakage cases. The use of haemostatic materials has for years been a recognized method of reducing the rate of intra- and postoperative complications, both in gastrointestinal surgery and in other surgical specialties. Based on the available studies, it can be concluded that the use of hemostatic materials such as matrices, sponges and adhesives in gastrointestinal surgery, even in patients at high risk of anastomotic leakage and bleeding complications, reduces the incidence of complications. The growing popularity of haemostatics and sealants in surgery means that they are currently used in a wide range of indications, and surgeons are more and more willing to use them even in case of standard surgical procedures, which is reflected in the available studies. Choosing a haemostat should be a conscious decision, taking into account the site and type of bleeding, mechanism of action, ease of use, efficacy, safety, and price, among others.
止血材料，如明胶海绵、氧化纤维素网片、组织密封剂、含有人凝血酶和纤维蛋白原的胶原基质，在胃肠外科中越来越受欢迎，特别是在结直肠外科中。我们在 Pubmed 和 Cochrane 数据库中搜索了关于在胃肠外科中使用各种止血材料的可用科学出版物。该分析重点评估了使用个别材料的安全性，包括出血并发症的发生率和吻合口漏的发生率。多年来，止血材料的使用一直是减少胃肠外科和其他外科专业术中及术后并发症发生率的公认方法。基于现有研究，可以得出结论，在胃肠外科中使用止血材料（如基质、海绵和粘合剂），即使在吻合口漏和出血并发症风险较高的患者中，也可以降低并发症的发生率。止血剂和密封剂在外科手术中的日益普及意味着它们目前被广泛应用于各种适应症，并且外科医生越来越愿意在标准手术过程中使用它们，这反映在现有的研究中。选择止血剂应该是一个有意识的决定，需要考虑出血部位和类型、作用机制、使用方便性、疗效、安全性和价格等因素。
