在冠状动脉旁路移植期间,可流动的原-ombin矩阵的静血疗效:一项双盲随机对照试验
Hyo-Hyun Kim1,2, Kang Ju Lee1, Dae Ryong Kang3
1Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, 250 Seongsanno, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Journal of cardiothoracic surgery
|June 15, 2023
概括
与Floseal® (凝止血矩阵) 相比,Collastat® (原止血矩阵) 在非冠状动脉旁路手术中显示出优越的止血和减少的输血需求. 这使得原血静矩阵成为安全有效的替代品.
科学领域:
- 心血管外科心血管外科
- 止血剂 止血剂 止血剂
- 生物材料是一种生物材料.
背景情况:
- 流动性静血剂对于不规则且难以进入的伤口表面是有利的.
- 科拉斯塔特 (Collastat®) (质静血矩阵,CHM) 和弗洛塞尔 (Floseal®) (凝静血矩阵,GHM) 是可流动的静血密封剂.
- 研究了CHM和GHM在非抽冠状动脉旁路手术 (OPCAB) 的有效性和安全性的比较.
研究的目的:
- 为了比较CHM与GHM在OPCAB手术中的有效性和安全性.
- 为了评估手术内静血成功率和静血的时间.
- 评估术后出血,输血需求,以及需要进行手术修复.
主要方法:
- 这是一项前性,双盲,随机对照试验,涉及160名接受选择性OPCAB的患者.
- 患者在动脉冠状动脉瘤的初级 suture后接受CHM或GHM (每个n=80).
- 终点包括血液静止成功,血液静止的时间,术后出血,输血率和手术修复.
主要成果:
- 100%的CHM组在5分钟内成功实现了静血,而GHM组的97.5% (非劣势p=0.006).
- 在GHM组中,有两名患者需要手术修复;在CHM组中,没有人需要手术修复.
- 医疗保健组对红细胞,新鲜冷血 (FFP) 和血小板的需求明显较低 (p<0.05).
结论:
- 与GHM相比,CHM成功实现了血液静止,并且与FPF和血小板输血的需求较低有关.
- 在OPCAB手术中,CHM是一种安全有效的GHM替代品,用于血液静止.
- 该研究发现,由于输血需求减少,CHM是潜在的优越选择.
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