医用胶原蛋白海绵治疗重度肝破裂的临床研究

目的：探讨医用胶原蛋白海绵对重度肝破裂创面的治疗作用。方法：将重度肝破裂患者以入院先后为序，随机分成治疗组（68例）和对照组（64例）。治疗组和对照组分别用医用胶原蛋白海绵片和明胶海绵片对肝创面进行止血和填塞。结果：治疗组的止血时间为(19.65±1.28)min，术中出血量为(301.57±56.18)mL均少于对照组［分别为(34.3±1.2)min及(642.3±61.8)mL］(均P<0.05)。治疗组术后腹腔引流量为(380.45±12.34)mL,并发胆瘘(1.5%)及再出血(3.0%)均少于对照组［分别为(693.2±219.4)mL,6.3%及9.5%］(均P<0.05);治疗组术后住院时间(24.01±4.89)d短于对照组(35.8±5.9)d(P<0.05)。术后CT复查显示治疗组创面肝组织修复时间(30.30+6.42)d短于对照组(62.1±7.2)d(P<0.05)。结论：胶原蛋白海绵对肝创面止血效力强于明胶海绵，与创面的黏附力强，术后并发症少，恢复快，是一种治疗肝破裂的有效、安全而可靠的生物材料。

Clinical study of medical collagen sponge in treatment of severe hepatic trauma

Abstract:Objective：To investigate the effects of placing medical collagen sponge on the wound surface for severe rupture of liver.Methods ：In 132 patients with severe hepatic trauma , 68 cases were randomly enrolled in collgan spong treatment group, in which the hepatic wound was treated with collagen sponge,while the 64cases in control group were treated with commonly used gelatin sponge. Results：The therapeutic results of collagan spong group were better than those of control group in the hemostatic time ［(19.65±1.28)min vs (34.3±1.2)min］, hemorrhagic volume ［(301.57±56.8)mL vs (642.3±61.8)mL］, abdominal cavity drainage volume［(380.45±12.34)mL vs (693.2±219.4)mL］, recovery time of hepatic tissue ［(30.30±6.42)d vs (62.1±7.2)d］, postoperation complications (re-bleeding , and hepatobiliary leakage) ［11.5% and 3.0% vs 6.3% and 9.5%］, and hospital time stay ［(24.01±4.89)d vs (35.8±5.9)d］ (all with P<0.05 ). Conclusions：The collagen sponge has stronger effect than gelatin sponge for hemostasis of liver wound. It can closely adhere to surface of wound, the postoperative complications were few and postoperative recovery was fast . Collagen sponge is an excellent and safe biologic material for hepatic trauma.