不同生物止血材料研究进展及复合型止血材料的临床应用

摘要

背景:随着生物医用高分子材料如纤维素、甲壳素等天然高分子材料以及聚乙烯醇、胶原等合成高分子材料的研发,止血材料的运用和发展获得了飞跃.目的:文章综述了近年来不同种类高分子止血敷料的研究进展,评价了不同种类复合止血敷料的临床应用价值.方法:应用计算机检索万方和PubMed数据库中1996-01/2010-12关于医用高分子止血敷料研究应用的文章,在标题和摘要中以"止血材料;纤维蛋白;高分子材料;胶原蛋白;明胶海绵"或"biological;occlude the flow of blood;gelatin sponge; fibrae sanguis"为检索词进行检索.选择医用高分子止血敷料领域发表在近期文献或权威杂志上的文章.初检得到126篇文献,根据纳入标准选择28篇文章进行综述.结果与结论:近年来国内外主要应用的可吸收止血材料包括壳聚糖、纤维蛋白胶、吸收性明胶海绵、微纤维胶原等以及常用的按材质和用途分类的藻酸盐类和水胶体类,不同的止血材料其止血机制和止血效果均不相同.文章通过对多种复合止血材料的效果进行比较观察,说明了各种止血材料止血途径和止血机制还有待进一步的研究,以便于开发出更卓越、更有效的止血材料.%BACKGROUND: With development of biomedical polymers, such as cellulose, chitin, polyvinyl alcohol and collagen, the application of materials for hemostasis has advanced.OBJECTIVE: To summarize advances in dressing materials for hemostasis and evaluate their clinical values.METHODS: A computer-based online search of Wanfang and PubMed database was performed for articles regarding medical polymer dressing materials for hemostasis published between January 1996 and December 2010 with key words “materials for hemostasis, fibrin, polymers, collagen, gelatin sponge” in Chinese or “biological; occlude the flow of blood; gelatin sponge; fibrae sanguis”. Articles published recently in authoritative journals of the same domain were selected. 126 articles were collected, and 28 were included for review analysis.RESULTS AND CONCLUSION: In recently, absorbable materials for hemostasis, including chitosan, fibrin glue, absorbable gelatin sponge, microfiber collagen, alginate and hydrocolloid. Different materials have various mechanisms and hemostasis effects. Comparisons in the effects of various compound materials for hemostasis showed that the pathways and mechanisms of different materials for hemostasis require further investigation to develop more effective and convenient materials for hemostasis.