多聚糖术中止血装置用于上消化道动脉性出血的动物实验研究
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苏州大学附属第一医院消化内科

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Evaluation of polysaccharide hemostatic system for arterial hemorrhage of upper digestive tract
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Department of Gastroenterology,the First Affiliated Hospital of Soochow University

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    摘要:

    目的 验证EndoClot多聚糖术中止血装置(EndoClot polysaccharide hemostatic system,EndoClot PHS)用于肝素化上消化道动脉性出血(Forrest Ⅰa)内镜下治疗的有效性和安全性。方法 将12只巴拿马猪以计算机简单随机分组的方法随机分为实验组(n=6)和对照组(n=6),建立胃动脉性出血动物模型。实验组和对照组分别使用Endoclot PHS和Hemospray喷洒创面止血,胃镜下持续观察30 min,比较2组达到有效止血的时间、止血颗粒使用量、送粉管堵塞及更换次数等。术后观察实验猪存活情况,并发症发生情况等。10 d后,所有实验猪行安乐死并行病理解剖。结果 12只实验猪均达到喷射性或搏动性出血。实验组和对照组达到有效止血的时间[(8.75±0.84) min比(9.83±0.62) min,t=-2.53,P=0.030]及达到有效止血的止血颗粒使用量[(6.71±0.39) g 比(14.10±1.62) g,t=-10.86,P<0.001]比较差异均有统计学意义。2组送粉管堵塞及更换次数差异无统计学意义[(0.64±0.02)次比(0.67±0.04)次,t=-1.64,P=0.131]。实验组气源更稳定,内镜下视野更清晰。实验组和对照组均未出现胃损伤、穿孔及气栓形成,血糖、血常规和肝肾功能均正常,均未出现主要器官的血栓形成及栓塞。结论 EndoClot PHS用于肝素化上消化道动脉性出血(Forrest Ⅰa)动物模型的内镜下治疗是安全有效的。

    Abstract:

    Objective To study the efficacy and safety of EndoClot polysaccharide hemostatic system (EndoClot PHS) for heparinized arterial hemorrhage of upper digestive tract (Forrest Ⅰa) in animal model. Methods Twelve experimental pigs were randomly divided into the test group (n=6) and the control group (n=6) by simple random grouping method. Gastric arterial hemorrhage models were established. Endoclot PHS and Hemospray were used to spray on the wound to stop bleeding in the test group and the control group respectively. The time of effective hemostasis, the amount of hemostatic particles used, and the blockage of the powder feeding tube and its replacement were compared between the two groups. The survival and complications of experimental pigs were observed after the operation. In 10 days after the operation, the experimental pigs were euthanized for pathological dissection. Results Spurting or pulsatile bleeding was achieved in all experimental pigs. There were significant differences in the time of effective hemostasis (8.75±0.84 min VS 9.83±0.62 min, t=-2.53, P=0.030) and the amount of hemostatic particles used to achieve effective hemostasis (6.71±0.39 g VS 14.10±1.62 g, t=-10.86, P<0.001) between the test group and the control group. There was no significant difference in the occurence of clogging or the replacement of powder feeding pipes between the two groups (0.64±0.02 times VS 0.67±0.04 times, t=-1.64, P=0.131). In addition, the gas source of the test group was stable, and the visual field under the endoscope was clear. Neither the test group nor the control group had gastric lesions, perforation, or embolism. The blood glucose, blood routine, and liver and kidney functions were normal, and no thrombosis or embolism of the main organs occurred in either group. Conclusion EndoClot PHS is safe and effective for heparinized upper gastrointestinal arterial hemorrhage (Forrest Ⅰa) in animal models.

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孙逸斌,陈晨,熊羽佳,等.多聚糖术中止血装置用于上消化道动脉性出血的动物实验研究[J].中华消化内镜杂志,2022,39(7):559-563.

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  • 收稿日期:2020-02-22
  • 最后修改日期:2022-02-27
  • 录用日期:2020-03-23
  • 在线发布日期: 2022-07-29
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