Spoeler Violetta C, Kipp Markus, Dubinski Daniel, Bernstock Joshua D, Rafaelian Artem, Trnovec Svorad, Lang Cajetan I, Freiman Thomas M, Ridwan Sami, Prall Friedrich, Gessler Florian, Won Sae-Yeon
Department of Neurosurgery, Rostock University Medical Center, 18057 Rostock, Germany.
Institute of Anatomy, Rostock University Medical Center, 18057 Rostock, Germany.
Pharmaceuticals (Basel). 2025 Apr 6;18(4):533. doi: 10.3390/ph18040533.
: Hydrogen peroxide (HO) is a well-known hemostatic and antiseptic agent in neurosurgical practice. While there are concerns regarding the use of HO due to its potential for neuronal damage, the pathophysiological effect on neuronal cells is not clearly understood. : An online survey concerning the use of HO was conducted in a board-certified platform, and an experimental study was designed to investigate the effect of HO on neuronal and tumor cells. Brain tissues of mice and brain/tumor tissues of humans were irrigated with HO 3%, HO 1.5%, and NaCl 0.9%, and processed by bipolar coagulation. Tissue sections were obtained and stained with H&E and analyzed by the depth and degree of neuronal damage measured from the cortical surface (μm). : In total, 242 neurosurgeons participated in the survey, and 81% of neurosurgeons reported use of HO in neurosurgical practice. however only 5% of the participants had a literature-based knowledge of the pathophysiological mechanism of HO. In total, eight mouse brain tissues, 21 human brain tissues, and seven human tumor tissues were processed and analyzed. The experimental study found that HO caused vacuolization of neuronal tissue in mouse brain tissues, with a mean depth of damage of 343.7 ± 39.7 μm after 2 min and 460.1 ± 36.4 μm after 10 min exposure to HO 3% ( < 0.001). In human brain tissues, vacuolization was detected in sections exposed to HO 1.5% and 3%, with a mean depth of damage of 543.8 ± 304.5 μm and 859.0 ± 379 μm ( = 0.003). In the bipolar coagulation group, the mean depth of neuronal damage, of 2504 ± 1490 μm, was nearly three times greater than that in the HO group ( < 0.001). Similar results were observed in human tumor tissues as well. : HO seems to cause less local damage on neuronal and tumor cells than conventional bipolar cauterization, suggesting it as a good alternative to be used for hemostasis and marginal tumor cell treatment. However, due to its potential risk for embolism, HO should be used with caution.
过氧化氢（HO）是神经外科手术中一种广为人知的止血和防腐剂。尽管由于其可能对神经元造成损伤而对使用HO存在担忧，但对神经元细胞的病理生理影响尚不清楚。
在一个经过认证的平台上进行了一项关于HO使用情况的在线调查，并设计了一项实验研究来调查HO对神经元和肿瘤细胞的影响。用3%的HO、1.5%的HO和0.9%的氯化钠对小鼠脑组织和人类脑/肿瘤组织进行冲洗，然后通过双极电凝进行处理。获取组织切片，用苏木精和伊红染色，并根据从皮质表面测量的神经元损伤深度和程度（μm）进行分析。
共有242名神经外科医生参与了调查，81%的神经外科医生报告在神经外科手术中使用过HO。然而，只有5%的参与者对HO的病理生理机制有基于文献的了解。总共对8个小鼠脑组织、21个人脑组织和7个人类肿瘤组织进行了处理和分析。实验研究发现，HO导致小鼠脑组织中的神经元组织空泡化，在暴露于3%的HO 2分钟后，平均损伤深度为343.7±39.7μm，暴露10分钟后为460.1±36.4μm（P<0.001）。在人类脑组织中，在暴露于1.5%和3%的HO的切片中检测到空泡化，平均损伤深度分别为543.8±304.5μm和859.0±379μm（P=0.003）。在双极电凝组中，神经元损伤的平均深度为2504±1490μm，几乎是HO组的三倍（P<0.001）。在人类肿瘤组织中也观察到了类似的结果。
与传统的双极烧灼相比，HO似乎对神经元和肿瘤细胞造成的局部损伤较小，这表明它是用于止血和边缘肿瘤细胞治疗的一个很好的替代方法。然而，由于其潜在的栓塞风险，应谨慎使用HO。
