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不同止血剂应用对颏神经影响的评估

Evaluation of the effects of different hemostatic agent applications on mental nerve.

作者信息

Adak Berat Metin, Laçin Nihat, Şimşek Fatma, Uysal Ersin, Soylu Fahri Emrah, Özkan İrem

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Katip Çelebi University, 6780.sokak no: 48 Cigli, Izmir, Turkey.

Department of Histology and Embryology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5355-5362. doi: 10.1007/s00405-022-07434-3. Epub 2022 Jun 29.

Abstract

PURPOSE

Evaluating the effect of ABS (Ankaferd Blood Stopper), Tranexamic Acid (Transamin) and Thrombin-Containing Hemostatic Matrix (Floseal) on the mental nerve of rats by using histopathologic and immunohistochemical analyses.

MATERIALS AND METHODS

40 Wistar Albino rats were used. Rats were randomly selected into 4 groups as Control (G1), ABS (G2), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4). In the control group G1, the left mental nerve was exposed and 0.3 ml of sterile saline was applied for 5 min, then closed with suture. In the other three groups, the left mental nerve was exposed and 0.3 ml ABS, Tranexamic Acid and Floseal was applied to groups, respectively. After 5 min, wounds were closed with suture. Immunohistochemical and histopathologic examinations were performed on mental nerves after 28 days.

RESULTS

The total histopathologic and immunohistochemical semiquantitative scores were significantly higher in ABS (G2) compared to Control (G1), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4) (P < 0.05). Myelin thickness were significantly lower in G2 compared to G1, G2 and G3 (P < 0.05). G3 has the most reliable results compared to G2 and G4 (P < 0.05).

CONCLUSION

The study results suggest that ABS has neurotoxic effects and should not be used close to the nerve, and thrombin-containing hemostatic matrix should be used carefully. Tranexamic acid, on the other hand, was found to be the most reliable hemostatic agent for use in close proximity to neural tissues. Further studies are required to determine the efficacy of the hemostatic agents on peripheral nerve degeneration.

摘要

目的

通过组织病理学和免疫组织化学分析,评估安卡非德止血剂(ABS)、氨甲环酸(凝血酸)和含凝血酶止血基质(弗洛塞尔)对大鼠颏神经的影响。

材料与方法

使用40只Wistar白化大鼠。将大鼠随机分为4组,即对照组(G1)、ABS组(G2)、氨甲环酸组(G3)和含凝血酶止血基质组(G4)。在对照组G1中,暴露左侧颏神经,应用0.3毫升无菌生理盐水5分钟,然后缝合关闭。在其他三组中,暴露左侧颏神经,分别向各组应用0.3毫升ABS、氨甲环酸和弗洛塞尔。5分钟后,缝合关闭伤口。28天后对颏神经进行免疫组织化学和组织病理学检查。

结果

与对照组(G1)、氨甲环酸组(G3)和含凝血酶止血基质组(G4)相比,ABS组(G2)的组织病理学和免疫组织化学半定量总分显著更高(P < 0.05)。与G1、G2和G3相比,G2组的髓鞘厚度显著更低(P < 0.05)。与G2和G4相比,G3组的结果最可靠(P < 0.05)。

结论

研究结果表明,ABS具有神经毒性作用,不应在神经附近使用,含凝血酶止血基质应谨慎使用。另一方面,发现氨甲环酸是在神经组织附近使用的最可靠止血剂。需要进一步研究以确定止血剂对周围神经变性的疗效。

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