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富白细胞和血小板纤维蛋白在颅外科手术中的应用:一项前瞻性、平行分组、单盲随机对照非劣效性临床试验的研究方案 {1}。

Leukocyte- and platelet-rich fibrin in cranial surgery: study protocol for a prospective, parallel-group, single-blinded randomized controlled non-inferiority trial {1}.

机构信息

Research Group Experimental Neurosurgery and Neuroanatomy and the Leuven Brain Institute, Department of Neurosciences, KU Leuven, Leuven, Belgium.

Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium.

出版信息

Trials. 2023 Mar 23;24(1):219. doi: 10.1186/s13063-023-07252-w.

Abstract

BACKGROUND

CSF leakage is a major complication after cranial surgery, thus, adequate dural closure must be performed. Commercially available fibrin sealants are currently considered the gold standard for dural closure, but problems have been reported regarding safety, efficacy, and costs. This trial aims to investigate autologous leukocyte- and platelet-rich fibrin (L-PRF) as an alternative to commercially available fibrin sealants.

METHODS/DESIGN: This single-blinded, prospective randomized controlled interventional trial aims to demonstrate the non-inferiority of L-PRF compared to commercially available fibrin sealants for dural closure. This trial will include patients undergoing cranial neurosurgery (supratentorial and infratentorial) with intentional opening of the dura. Patients are randomized in a 1:1 fashion comparing L-PRF to commercially available fibrin sealants. The primary endpoint is postoperative CSF leakage within 12 weeks after surgery. Secondary endpoints are complications such as bleeding or wound infections. Additionally, a cost-effectiveness analysis is performed.

DISCUSSION

With this trial, we will evaluate the safety and efficiency of L-PRF compared to commercially available fibrin sealants.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03812120. Registered on 22 January 2019.

摘要

背景

脑脊液漏是颅脑手术后的主要并发症,因此必须进行充分的硬脑膜关闭。目前,市售纤维蛋白胶被认为是硬脑膜关闭的金标准,但安全性、有效性和成本方面存在问题。本试验旨在研究自体白细胞和血小板富纤维蛋白(L-PRF)作为市售纤维蛋白胶的替代物。

方法/设计:这是一项单盲、前瞻性随机对照干预试验,旨在证明 L-PRF 与市售纤维蛋白胶在硬脑膜关闭方面的非劣效性。该试验将纳入接受颅神经外科手术(幕上和幕下)且硬脑膜有意切开的患者。患者以 1:1 的比例随机分为 L-PRF 组和市售纤维蛋白胶组。主要终点是术后 12 周内的术后脑脊液漏。次要终点是出血或伤口感染等并发症。此外,还进行了成本效益分析。

讨论

通过这项试验,我们将评估 L-PRF 与市售纤维蛋白胶相比的安全性和效率。

试验注册

ClinicalTrials.gov NCT03812120。于 2019 年 1 月 22 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c129/10035267/fd44d7c07e2d/13063_2023_7252_Fig1_HTML.jpg

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