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[纤维蛋白粘合剂贝里普拉斯在心脏手术中的初步临床经验]

[Initial clinical experiences with the fibrin adhesive Beriplast in heart surgery].

作者信息

Stenzl W, Tscheliessnigg K H, Dacar D, Rigler B

出版信息

Wien Med Wochenschr. 1985 Oct 31;135(19-20):506-11.

PMID:4072235
Abstract

Fibrin glue Beriplast was used during cardiovascular surgery in 97 patients. The fibrin seal was used for hemostasis on anastomoses, patches and suture lines. Moreover, the glue was applied for epicardial fixation of aorto-coronary vein grafts to prevent postoperative graft kinking. Following extrapleural ligation of patent duct in premature infants, the parietal pleura was fastened to the thoracic wall to prevent extrapleural pneumothorax or hemorrhage. After accidental dissection of the thoracic duct in infants, leakage of chyle could be sealed successfully in 6 cases. Hemorrhage from the sealed surfaces of suture lines was not observed. Viral hepatitis occurred postoperatively in 2 patients (3% of the operations for acquired heart disease), both of whom had also received clotting factor concentrate and blood transfusion because of postoperative hemorrhage not related to fibrin sealed surfaces. A causal relation between the hepatitis and application of the pasteurized fibrin glue seems very unlikely. Although fibrin glue certainly cannot replace the surgical suture, it appears to be a valuable aid under special conditions.

摘要

97例患者在心血管手术中使用了贝里普拉斯纤维蛋白胶。纤维蛋白封闭剂用于吻合口、补片和缝合线的止血。此外,该胶水还用于主动脉-冠状动脉静脉移植物的心外膜固定,以防止术后移植物扭结。在早产儿动脉导管未闭行胸膜外结扎术后,将壁层胸膜固定于胸壁,以防止胸膜外气胸或出血。婴儿胸导管意外切断后,6例乳糜漏得以成功封闭。未观察到缝合线封闭表面出血。2例患者(占后天性心脏病手术的3%)术后发生病毒性肝炎,这两名患者均因与纤维蛋白封闭表面无关的术后出血接受了凝血因子浓缩物和输血。肝炎与巴氏消毒纤维蛋白胶的应用之间似乎不太可能存在因果关系。虽然纤维蛋白胶肯定不能替代手术缝线,但在特殊情况下它似乎是一种有价值的辅助手段。

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