新型止血材料SURGICELTM和明胶海绵在神经外科手术中的应用

背景：新型止血材料SURGICELTM在其他科室显微手术中已取得较好的临床效果，而在神经外科中尚无前瞻性随机对照的研究结果报道。 目的：比较明胶海绵和新型止血材料SURGICELTM控制神经外科术中出血及局部渗血的效果。　 方法：选择苏州市立医院神经外科2008-04/2010-12进行颅脑手术的患者60例，按随机数字表法分为SURGICELTM止血组30例和明胶海绵止血组30例。术中各自使用这两种止血材料进行止血。 结果与结论：明胶海绵止血组止血失败率为10%(3/30)，显著高于SURGICELTM止血组3%(1/30)]，差异有显著性意义(P < 0.05)。SURGICELTM止血组止血时间为(2.43±  0.75) min，明胶海绵止血组止血时间为(4.23±0.89) min，两组比较差异有显著性意义(P < 0.05)，术后均未发生过敏反应和排斥反应。新型止血材料SURGICELTM较传统明胶海绵可以更迅速地控制神经外科手术中的出血及局部渗血，止血成功率明显提高。

Clinical hemostasis effect of a novel hemostatic material SURGICELTM versus gelatin sponge in neurosurgery

BACKGROUND: A novel hemostatic material SURGICELTM has achieved good clinical results in the micro-surgery of many sections, and in neurosurgery, there is no prospective randomized controlled study reported. OBJECTIVE: To compare the efficacy of SURGICELTM and gelatin sponge in the management of active and local bleeding in neurosurgery. METHODS: Sixty patients undergoing cranial neurosurgery in the Department of Neurosurgery, Suzhou Municipal Hospital between April 2008 and December 2010 were randomized into the SURGICELTM group (n=30) and gelatin sponge group (n=30) with the use of SURGICELTM and gelatin sponge as hemostatic materials, respectively. RESULTS AND CONCLUSION: One case of hemostasis failed in the SURGICELTM group, whereas 3 cases failed in the gelatin sponge group. The failure rate of the gelatin sponge group was 10%, significantly higher than that of the SURGICELTM group (3%, P < 0.05). The mean hemostasis time in the SURGICELTM group and gelatin sponge group was (2.43±0.75) and (4.23±0.89) minutes, respectively, showing a significant difference between the two group (P < 0.05). No allergic reaction and rejection occurred postoperatively. SURGICELTM allows faster hemostatic effect and larger hemostatic success rate than gelatin sponge during neurosurgeries.