Gelatamp胶质银明胶海绵在前牙区Ⅱ型种植位点的临床应用研究

目的:观察Gelatamp胶质银明胶海绵在前牙区Ⅱ型种植位点的临床应用效果。方法:选择40例前牙区拔牙拟作Ⅱ型种植的病人,随机分层分为Gelatamp胶质银明胶海绵填塞止血组(试验组)及棉球压迫止血组(对照组)。拔牙后,试验组在牙槽窝置入Gelatamp胶质银明胶海绵,对照组常规紧咬棉球30分钟后取出,观察比较两组的止血效果和4周后行Ⅱ型种植手术前拔牙位点软组织愈合的情况。结果:试验组拔牙创出血很快停止,出血平均时间为0.67分,试验组、对照组止血效果有效率分别为100%,80%,差异有统计学意义(P<0.05)。在4周后Ⅱ型种植手术前试验组、对照组的软组织愈合良好率分别为70%和40%,差异有统计学意义(P<0.05)。结论:Gelatamp胶质银明胶海绵,能显著缩短出血时间,有效增强止血效果,具有止血和持久杀菌的双重效果,有利于形成良好的软组织,有利于早期种植体植入后封闭创面,具有一定的临床应用价值。     

明胶海棉填塞法在龈乳头出血应急处理中的应用

目的：探讨明胶海绵填塞法在龈乳头出血应急处理中的疗效。方法：在口腔科门急诊随机选取龈乳头出血患者63例，将明胶海绵块搓捻成条索状，楔人患者出血龈乳头所在的牙间隙中，2d后复诊观察填塞后的止血效果。结果：包括1例腭大动脉破裂大出血在内的63例龈乳头出血患者，经过明胶海绵牙间隙填塞，复诊皆未发现再次出血。结论：在龈乳头出血的应急处理中，明胶海绵牙间隙填塞法操作简单、止血效果明确，值得临床推广应用。     

腭裂松弛切口填塞明胶海绵80例的临床观察

目的比较腭裂修复术松弛切口填塞明胶海绵和填塞碘仿纱条的效果。方法160例腭裂修复术患者,填塞明胶海绵80例,填塞碘仿纱条80例,观察2组患者术后体温、出血量、创口愈合情况,以及饮食、术后并发症的情况。结果填塞明胶海绵组术后体温升高发生率低于填塞碘仿纱条组,创口愈合时间、恢复正常饮食时间早于后者,术后出血少。结论腭裂松弛切口填塞明胶海绵比填塞碘仿纱条更有利于患者术后的恢复。     

激光在拔牙创出血治疗上的临床应用(摘要)

拔牙后出血的治疗 ,过去常采取注射止血针剂、ＦｅＣｌ3 烧灼、明胶海绵充填等方法 ,虽有效 ,但不理想。我所自 1991年起采用激光照射拔牙创止血法 ,经过五年多的临床应用 ,结果拔牙后 5分钟止血率为 79% ,15分钟止血率为 92 % ,30分钟止血率为 98% ,效果较满意 ,出血时间缩短明显 ,创面愈后良好。激光在拔牙创出血治疗上的临床应用(摘要)@焦红卫$上海市口腔病防治院!200011     

抗凝血与抗血小板治疗老年患者拔牙的临床研究

目的：观察抗凝血治疗和抗血小板治疗的老年患者拔牙术后出血及拔牙创的愈合,评价拔牙术后明胶海绵加缝合创口的止血效果。方法：老年患者分为抗凝血治疗需要拔牙组、抗血小板治疗需要拔牙组和随机选择需要拔牙的老年患者作正常对照。抗凝血治疗组拔牙前均进行凝血酶原时间国际标准化率检测。三组均采用局部纱布压迫止衄,比较拔牙术后出血情况,拔牙术后出血的病人采用局部明胶海绵加缝合创口处理。结果：抗凝血治疗与其他2组出血有显著性差异,3组均未出现局部不可控制的出血;3组创口愈合没有明显差别。结论：接受抗凝血治疗和抗血小板治疗的老年病人,在不停药和不减少药物剂量的情况下可以行拔牙术,明胶海绵加上局部缝合可达到止血目的。     

埋伏阻生齿拔除术后两种拔牙窝填塞剂对预后的影响

目的 观察骨埋伏阻生牙拔除术后两种不同的牙槽窝填塞剂对预后的影响。方法 选取315例骨埋伏的下颌第三磨牙拔除的患者,随机分成3组,组1拔除术后创面直接拉拢缝合+口服镇痛+口服抗炎;组2拔除术后创面明胶海绵+碘仿粉末填塞止血+拉拢缝合+口服镇痛+口服抗炎;组3拔除术后创面胶质银明胶海绵(止泰)填塞止血+拉拢缝合+口服镇痛+口服抗炎。比较3组术后出血,术后肿痛及术后干槽症的发生率。结果 组2和组3创面处理治疗后的术后出血,术后肿痛及术后干槽症的出现明显降低,预后优于组1(P<0.01),且组2和组3两组之间差异无统计学意义(P>0.05)。结论 胶原蛋白海绵+碘仿粉末或胶质银明胶海绵的两种术后创面处理方法皆疗效显著,值得临床进一步推广和应用。     

口腔可溶性羟乙基止血纱布的止血性能及生物相容性研究

[摘要] 目的 观察羟乙基可溶性止血纱布在口腔中的止血性能及其对人牙龈成纤维细胞增殖的影响。方法 制备可溶性止血纱布和其他止血材料的细胞培养浸提液,采用四唑盐比色分析法（MTT）测定材料对人牙龈成纤维细胞生长的影响。结果 可溶性止血纱布在人工唾液中的溶解速度较快,它的体外凝血指数比医用纱布和明胶海绵低,差异有统计学意义（P<0.05）,可溶性止血纱布和明胶海绵的细胞相对增值率没有明显差异（P>0.05）,细胞的毒性级别均为0-1级。结论 可溶性止血纱布的溶解性、止血效果较好,对人牙龈成纤维细胞没有明显细胞毒性。     

腭裂创面不同处理方法的比较

目的:对比腭裂患者术中创面不同的处理方法对其术后恢复的影响。方法:选择210例腭裂手术患者,随机分为实验组和对照组。实验组采用缝扎创缘及明胶海绵填塞创面,对照组应用碘仿纱包及碘仿纱条填塞创面,评价两组病例术后出血情况及饮食精神恢复时间的差异。结果:实验组患者术后饮食、精神恢复早,出血少。结论:腭裂术中采用缝扎创缘及明胶海绵填塞可替代传统的碘仿纱包或纱条的应用。     

上前牙即刻种植开放式愈合的临床研究

目的 探索上前牙即刻种植开放式愈合使用明胶海绵预防感染及植入材料脱漏的可行性。方法 即刻种植体周围缺隙大于1mm时，植入自体骨和（或）Bio-Oss骨粉。观察组把吸有自体血及甲硝唑粉的明胶海绵压成薄膜，覆盖种植体创面，无张力缝合创口但不完全关闭。对照组不用明胶海绵薄膜，在创面放入甲硝唑粉，其余过程相同。结果 观察组25颗中22颗获得成功。对照组12颗成功7颗．经X^2检验P〈0．05，结果有显著性差异。结论 在初期创口不严密关闭的上前牙即刻种植中，用含有药物和自体血的明胶海绵薄膜覆盖创口面能起到促进伤口愈合及防感染和防止植入材料脱漏的作用，有助于种植成功。     

血友病患者口腔出血的处理

目的 探讨血友病患者口腔出血的临床特点及处理方法。方法 对19例血友病口腔出血患者临床资料进行分析讨论。结果 12例用细针细线严密缝合、明胶海绵、碘酚棉球填塞等局部处理后止血成功，7例术后经输入凝血因子Ⅷ、输全血等综合措施止血。结论 对血友病患者的口腔牙槽窝粘膜出血可采用明胶海绵、碘酚棉球填塞止血。口腔软组织损伤出血采用细针细线严密缝合止血，术后采用输入凝血因子Ⅷ、输全血等方式综合处理。     

A comparative evaluation of hemostatic agents in the management of soft tissue graft donor site bleeding

BACKGROUND: Periodontal plastic surgery has increased the use of palatal wounds for donor tissue, with the most common complication being excessive bleeding from the palate after harvesting tissue. This study was conducted to evaluate the efficacy of 3 methods for achieving hemostasis on the palate after harvesting donor tissue for autogenous soft tissue grafts. METHODS: Thirty sites were evaluated at surgery for hemostasis and followed over 21 days for healing and adverse events. Three treatment groups were randomly selected and patients received either a test product or control comprising: 1) oxidized regenerated cellulose; 2) absorbable gelatin sponge; or 3) sterile gauze with external pressure as the control. All patients received a surgical stent for the palate. RESULTS: The results were analyzed for smokers and non-smokers, and the median time to hemostasis was significantly shorter when a hemostatic agent was applied to the palatal wounds compared to controls in both groups. Pain assessment showed no differences across treatment groups. However, by 21 days, only the oxidized regenerated cellulose group had complete healing based on blinded clinical evaluation with all sites rated as normal to rapid healing, compared to the absorbable gelatin sponge group where 40% of the sites were rated as slow healing. Adverse events, primarily bleeding episodes during the first 7 days after surgery, were found in 40% of the oxidized regenerated cellulose and gauze control groups, while no sites in the absorbable gelatin sponge group had an adverse event. The patients were followed for an average of 10 months and demonstrated a mean shrinkage of their recipient grafts of 24% in total surface area. CONCLUSIONS: This study concluded that the use of hemostatic agents for palatal wounds is confirmed as the treatment of choice when performing free soft tissue grafts.     

The effects of hemostatic agents on peripheral nerve function: an experimental study.

PURPOSE: In the practice of oral and maxillofacial surgery, hemostatic agents are sometimes placed in close proximity to peripheral nerves. In the present study, we evaluated immediate and delayed effects of 4 hemostatic agents (oxidized regenerated cellulose, 5% colloid silver-added gelatine sponge, bovine collagen, bone wax) on peripheral nerve function. MATERIALS AND METHODS: A total of 25 rat sciatic nerves were prepared, and the amplitudes were recorded with a physiological data acquisition system. Animals were randomly assigned to 5 groups: control, oxidized regenerated cellulose, gelatine sponge, bone wax, and bovine collagen. The first hour records are defined as immediate effects of these hemostatic agents on nerve function. The animals were then allowed to recover for 4 weeks. At the end of this period, the same surgical and recording procedures were performed. These final records are defined as delayed effects of hemostatic agents on nerve function. According to nerve conduction velocity (NCV) and compound action potential (CAP) values of the experimental groups, early and delayed effects of each hemostatic agent were statistically compared with Bonferroni corrected test (P < .05). RESULTS: Statistically, NCV was significantly reduced, and the CAP was significantly increased 1 hour after surgery (P < .05) in the group of oxidized regenerated cellulose. However, there were no significant differences after 4 weeks compared with the first records. In the gelatine sponge group, CAP was significantly increased 4 weeks after the application. In the bovine collagen and bone wax groups, NCV and CAP values (1 hour and 4 weeks after the application) were not statistically significant compared with initial control records. CONCLUSION: The present study shows that bovine collagen is the most suitable hemostatic agent applicable for peripheral nerves.     

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目的    研究腭裂术后松弛切口两种不同处理方法的患者术后反应及愈合情况。方法    将2007年8月至2009年7月在安徽省蚌埠医学院第一附属医院口腔科住院治疗的腭裂患者185例随机分为治疗组（93例）和对照组（92例），治疗组患者术后松弛切口内置入明胶海绵并进行对位缝合；对照组按照传统方法填塞碘仿纱条。比较两组患者术后体温、出血、进食、创口愈合等情况。结果    治疗组患者术后1例感染，12例发热，8例继发性出血；对照组术后12例感染，35例发热，25例继发性出血；两组间比较差异有统计学意义。治疗组1例术后穿孔，而对照组术后5例穿孔，两组术后均无复裂患者；两组间差异无统计学意义。结论    松弛切口内置入明胶海绵并进行对位缝合有利于腭裂术后恢复，是比较好的一种方法。     

康复新明胶海绵预防急性炎症期拔牙术后并发症的临床应用

目的观察康复新明胶海绵在预防急性炎症期拔牙术后并发症的效果。方法随机选择无明显全身疾患的急性炎症期拔牙者，用碘仿纱条（A组）和康复新明胶海绵（B组），预防术后并发症，并选择急性症期拔牙未作预防性填塞（C组）和非炎症组（D组）作对照，观察各组（均为100例）术后并发症。结果经统计学处理，显示C组术后并发症发生率明显高于D组。A组与B组术后并发症发生率与D组无明显差异。A组与B组比较术后并发症差异无显著性，在适应性方面B组优于A组。结论急性炎症期拔牙术后以康复新明胶海绵作预防性填塞有助于减少并发症且患者更易接受。     

盐酸米诺环素复合明胶海绵治疗干槽症的临床研究

目的:比较盐酸米诺环素复合明胶海绵与碘仿纱条治疗干槽症的疗效。方法:58例确诊为干槽症的患者经常规清创后,随机均分为2组。实验组牙槽窝内置入盐酸米诺环素复合明胶海绵;对照组填塞碘仿纱条,随访比较其疗效。结果:组间比较[实验组/对照组:优(例)23/16;良(例)6/11;可(例)0/2],Kruskal-Wallis检验法检验,疗效评价等级为"优"的实验组病例数多于对照组(P<0.05)。结论:盐酸米诺环素复合明胶海绵对干槽症的疗效优于碘仿纱条。     

Dental extractions in patients maintained on continued oral anticoagulant: comparison of local hemostatic modalities.

OBJECTIVE: The purpose of this study was to evaluate postoperative bleeding in patients treated with oral anticoagulant drugs who underwent dental extractions without interruption of the treatment and to compare the effect of 3 different hemostatic modalities. STUDY DESIGN: A total of 150 patients who underwent dental extractions were divided into 3 groups. Local hemostasis was carried out as follows: group 1 (119 extractions), with gelatin sponge and sutures; group 2 (117 extractions), with gelatin sponge, sutures, and mouthwash with tranexamic acid; group 3 (123 extractions), with fibrin glue, gelatin sponge, and sutures. RESULTS: Of 150 patients, 13 (8.6%) presented with postoperative bleeding: 3 patients from group 1, 6 patients from group 2, and 4 patients from group 3. CONCLUSIONS: Dental extractions can be performed without interruption in patients treated with oral anticoagulant. Local hemostasis with gelatin sponge and sutures is sufficient.     

胶原蛋白海绵用于下颌阻生牙拔除术的效果分析

目的:探讨在下颌阻生牙拔除术后应用胶原蛋白海绵的临床效果。方法:选取2016年11月—2017年11月在天津市口腔医院行下颌阻生牙拔除术的患者150例,随机分为常规组和胶原蛋白海绵组。胶原蛋白海绵组患者进行下颌阻生牙拔除术后在拔牙窝内填入胶原蛋白海绵,常规组患者则只进行常规拔牙处置,比较2组患者拔牙后的相关情况。采用SPSS 20.0软件包对数据进行统计学处理。结果:胶原蛋白海绵组患者拔牙后30 min内拔牙窝出血率显著低于常规组（P<0.05）,拔牙后第1天和第3天疼痛程度评分显著低于常规组（P<0.05）,拔牙后干槽症和其他并发症的发生率显著低于常规组（P<0.05）。结论:在下颌阻生牙拔除术后应用胶原蛋白海绵,不仅可以有效减少术后出血量,而且可以有效降低术后干槽症和其他并发症的发生率,值得推广应用。     

P物质促进磷酸钙-明胶复合材料支架修复颌骨缺损的研究

目的 构建自固化磷酸钙（CPC）-明胶复合组织工程材料支架,观察人工合成神经多肽P物质（SP）对其修复兔下颌骨缺损的作用 方法 鼠尾Ⅰ型胶原酸解冻干制备明胶海绵;模具制备8 mm×2 mm圆柱型材料支架,分为单纯CPC固化制成、CPC-明胶混合固化制成、CPC-明胶-SP混合固化制成三组;制备兔下颌骨直径8 mm圆柱状缺损动物模型,分别植入三种材料支架,术后12周X线和Micro CT检查支架形态与骨愈合情况。结果 扫描电镜显示CPC-明胶支架具有类似松质骨的超微结构;动物实验12周时CPC-明胶-SP支架与周围骨质基本融合,Micro CT显示材料内部成骨转化显著优于其他两组。结论 Ⅰ型胶原明胶与CPC混合调拌,操作简便,可随意塑形,并自行固化,具有类似松质骨的内部结构,人工合成神经多肽P物质可促进其在体内成骨转化。