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find Keyword "止血" 41 results
  • 完全清醒无止血带局部麻醉技术在手外科手术中的应用

    目的总结完全清醒无止血带局部麻醉技术(wide awake local anesthesia no tourniquet,WALANT)在手外科手术中的应用效果。方法 2021年4月—10月,采用WALANT为28例手外伤患者实施麻醉并手术。男18例,女10例,年龄15~55岁,平均35岁。急诊手术22例,择期手术6例。骨折切开复位内固定术5例,骨折内固定物取出术l例,肌腱探查断裂修复术18例,肌腱粘连松解术4例。采用疼痛视觉模拟评分(VAS)评估疼痛情况,术中观察出血情况,术后观察麻醉维持时间、手指血供变化及有无并发症发生,采用主动运动总和法(TAM)评定手部功能。结果 术中麻醉与止血效果满意,患者未诉疼痛。第1针刺入皮肤时VAS评分为2~4分;术中操作未引起明显疼痛,VAS评分为0~1分;麻醉效果可持续6~8 h,VAS评分为2~6分。术后手术区域麻醉效果逐渐消失后,所有患者口服或静脉滴注非甾体止痛药能有效缓解疼痛。术后24 h内患者无头痛、头晕、恶心、呕吐、乏力、皮疹等药物不良反应,术后8 h手指皮温及毛细血管反应同正常手指。术后未出现血运障碍等麻醉不良反应。28例患者均获随访,随访时间6~12个月,平均8个月。末次随访时TAM评定获优20例、良8例。结论手外科手术中应用WALANT止痛和止血效果良好、操作简单、安全有效,术中能即刻观察手术效果。

    Release date:2023-01-10 08:44 Export PDF Favorites Scan
  • EFFECTS OF A HEMOSTATIC JELLY WITH POLYLACTIC ACID ON HEMOSTASIS OF INJURED CANCELLOUS BONE

    Objective To prepare a self-made compound, hemostatic jelly with polylactic acid(PLA), which has the hemostatic and absorbable effect on injured cancellous bone. Methods Two bone defects of 5 mm in diameter and 4 mm in depth were subjected on 20 health rabbits by drilling through their either outside plate of the iliac, and were filled with hemostatic jelly(group A), bone wax(group B) and blank(group C) respectively. Hemostasis were observed and recorded after 1 and 10 minutes. Five specimens were harvested at 2, 4, 8 and 12 weeks postoperatively for histological observation. Results ① Hemostatic effect: Bleeding of injured spongy bone stopped within 10 minutes after the treatment of hemostatic jelly and bone wax, but bleeding of balnk did not stop. Hemostatic jelly and bone wax adhered to bone defects firmly within 10 minutes was after the treatment. ② Absorbable effect: Hemostatic jelly and bone defects have not changed visibly in the first 2 weeks. With histological observation 4 to 8 weeks after the operation, hemastatic jelly was absorbed gradually and replaced by osteogenous tissue. It was absorbed completely after 8 to 12 weeks. Bone wax was not absorbed after 12 weeks, no new bone tissue was observed at bone wax area. The blank was replaced by connective tissue and osteogenous tissue partially after 12 weeks. Conclusion The compound hemostatic jelly manifests both hemostatic and absorbable effects on injured cancellous bone and may substitute for bone wax in clinical application.

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • 超声引导在血液透析内瘘穿刺点压迫止血中的临床应用

    目的 探讨超声引导在血液透析内瘘穿刺点压迫止血中的临床应用。 方法 回顾性分析 2008 年 8 月—2015 年 10 月 36 例超声引导下血液透析内瘘穿刺点压迫止血的临床特点。36 例患者均为应用常规止血方法失败,而在超声引导下采用小方块形折叠纱布定点、垂直压迫出血点止血。 结果 36 例患者均使用超声引导定位法准确找到出血点,在 15~50 min 之内有效止血。 结论 超声引导小方块形折叠纱布定点、垂直压迫出血点止血法简单、安全、有效,为临床提供了又一实用的止血方法。

    Release date:2017-05-18 01:09 Export PDF Favorites Scan
  • APPLICATION OF LIMITED DECOMPRESSION COMBINED WITH VERTEBRAL PLATE RECONSTRUCTION ON TREATMENT OF SINGLE SEGMENT THORACIC VERTEBRA TUBERCULOSIS

    Objective To investigate the effectiveness in the treatment of single segment thoracic vertebra tuberculosis by limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation. Methods Between September 2005 and March 2010, 90 cases of single segment thoracic vertebra tuberculosis were treated by using limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation in 44 patients (treatment group) and by one-stage posterior approach, bone fusion, and internal fixation in 46 patients (control group). There was no significant difference in gender, age, disease duration, affected segment, Cobb angle, Frankle grade, erythrocyte sedimentation rate (ESR), and Oswestry disability index (ODI) between 2 groups (P gt; 0.05). Results All incisions healed by first intension. All 90 cases were followed up 24-44 months (mean, 38 months). There was no significant difference in ESR between 2 groups at 1 week and 3 months after operation (P gt; 0.05). Postoperative iconography indicated that the bone fusion rate of the treatment group was 100% and no epidural cicatricial tissue or failure of internal fixation was observed, showing significant difference when compared with control group (3 cases having failure of internal fixation) (P=0.032). The Cobb angles were significantly corrected after operation when compared with preoperative angles in 2 groups (P lt; 0.05). At 2 years after operation and at last follow-up, the Cobb angle and correction loss in treatment group were significantly better than those in control group (P lt; 0.05). The ODI and Frankel grade were significantly improved at last follow-up when compared with preoperative ones in 2 groups (P lt; 0.05); the treatment group was significantly better than the control group in the ODI, improvement rate of ODI (P lt; 0.05), and in Frankel grade (Uc=4.368, P=0.000). Conclusion Compared with conventional operation method, it is an ideal operation method to use limited decompression combined with epidural absorbable haemostat covering and vertebral plate reconstruction based on one-stage posterior approach, debridement, bone fusion, and internal fixation for treatment of single segment thoracic vertebra tuberculosis, with minimal wound, less complications, and good function recovery.

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • The hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries: a systematic review

    ObjectiveTo systematically review the hemostatic effect of traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat in surgeries. MethodsThe PubMed, Embase, CENTRAL, CNKI, VIP and WanFang Data databases were electronically searched to collect controlled studies related to the objectives from inception to September 18th, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 7 randomized controlled trials, 5 cohort studies and 9 animal experiments were included. The results of analysis showed that the group with traditional class Ⅲ hemostatic powder or aggregate absorbable hemostat had a higher hemostatic success rate and shorter hemostatic time than those with no hemostatic material in animal surgeries. And the group with aggregate absorbable hemostat had a higher 10 min hemostatic success rate than those with traditional hemostatic measures. The application of traditional class Ⅲ hemostatic powder in human cardiothoracic surgeries shortened the hemostatic time and reduced drainage after surgeries, but caused more blood loss during knee arthroplasties. Aggregate absorbable hemostat caused less blood loss than traditional hemostatic measures in human hip arthroplasties, and the 5 min and 10 min success rates of aggregate absorbable hemostat group were not worse than those of hemostatic gauze. ConclusionCurrent evidence shows that the hemostatic effect of both traditional class Ⅲ hemostatic powder and aggregate absorbable hemostat are better than that of no hemostatic material in animal and human surgery, but the comparison results between the two and with other hemostatic measures are still not clear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

    Release date:2025-08-15 11:23 Export PDF Favorites Scan
  • Application of Tranexamic Acid in Patients with Trauma-Related Hemorrhage

    ObjectiveTo review trauma-induced coagulopathy and use of tranexamic acid in patients with traumatic hemorrhage. MethodsThe relevant literatures about the definition and pathogenesis of trauma-induced coagulopathy, and the use of tranexamic acid in patients with traumatic hemorrhage were reviewed. ResultsTraumatic-induced coagulopathy was a coagulation disorder in the early stage after injury, which was associated with the anticoagu-lation and increasing activity of fibrinolysis. Tranexamic acid as an anti-fibrinolytic drug, it had a good result in clinical application, which could reduce the mortality due to bleeding in use within 3 h after injury, the effect was the best in use within 1 h after injury, but it had no benefit or even would increase the mortality due to hemorrhage in use >3 h after injury. There was no standardized dosage of tranexamic acid, but the volumes of blood loss and blood transfusion had no difference under the different dosages. However, high dosage or long-term use of tranexamic acid might increase the risk of the thrombosis or epilepsy. ConclusionEmergency traumatic patients face a series of death threats related trauma. Appropriate and timely hemostasis is important for prognosis. Early, short-term, and appropriate dosage of tranexamic acid could obviously reduce mortality and adverse events, but its timing and dosages need to be further optimized.

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  • EXPERIMENTAL STUDY ON HEMOSTASIS OF THERMOSENSITIVE CHITOSAN HEMOSTATIC FILM

    Objective To investigate the hemostasis of thermosensitive chitosan hemostatic film. Methods Fifty adult Sprague Dawley rats, male or female and weighing 190-210 g, were made the models of liver injury. The models were randomly divided into 5 groups (n=10) depending on different hemostatic materials. The incision of the liver was covered with the hemostatic materials of 2.0 cm × 1.0 cm × 0.5 cm in size: thermosensitive chitosan hemostatic film (group A), chitosan hemostatic film (group B), cellulose hemostatic cotton (group C), gelatin sponge (group D), and no treatment (group E), respectively. The bleeding time and bleeding amount were recorded. After 4 weeks, the incisions of the liver were observed with HE staining. Results Gross observation showed better hemostatic effect and faster hemostatic time in groups A, B, and C; group D had weaker hemostatic effect and slower hemostatic time; group E had no hemostatic effect. The bleeding time and bleeding amount of groups A, B, C, and D were significantly lower than those of group E (P lt; 0.05). The bleeding time and bleeding amount of groups A, B, and C were significantly lower than those of group D (P lt; 0.05), but no significant difference was found among groups A, B, and C (P gt; 0.05). The liver cells of group A had milder edema and ballooning degeneration than other 4 groups through histological observation. Conclusion The thermosensitive chitosan hemostatic film has good hemostasis effect on the liver incision of rats.

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • Guidelines interpretation of the ISTH guidelines for antithrombotic treatment in COVID-19

    The International Society on Thrombosis and Hemostasis (ISTH) recently released the first ISTH guideline for antithrombotic treatment of COVID-19, which provides recommendations on anticoagulant and antiplatelet agents for patients with COVID-19 in different clinical settings. The target audience includes clinicians in internal medicine, intensive care, infectious diseases, hematology, vascular medicine, residents, family physicians, and other health care providers providing inpatient or outpatient care to COVID-19 patients. This article interprets the important parts of ISTH guideline.

    Release date:2023-06-26 03:58 Export PDF Favorites Scan
  • Effectiveness of partial anterior cruciate ligament suture repair with wide awake local anesthesia no tourniquet technique

    ObjectiveTo investigate the effectiveness of partial anterior cruciate ligament (ACL) suture repair with wide awake local anesthesia no tourniquet (WALANT) technique.MethodsBetween July 2017 and July 2019, 18 patients with partial ACL injury were admitted. There were 10 males and 8 females, with an average age of 40.5 years (range, 22-57 years). There were 5 cases on the left knee and 13 cases on the right knee. Forteen cases had a clear history of trauma or sports injury, and 4 cases had no obvious cause. The time from injury to operation was 1-6 months (median, 3 months). Partial ligament was sutured using WALANT technique under arthroscopy. The operation time, total hospital stay, and postoperative hospital stay were recorded. Lachman test and anterior drawer test were performed to evaluate the knee joint stability after treatment, and Lysholm and International Knee Documentation Committee (IKDC) scores were used to evaluate the knee function. Five-point Likert scaling were used to evaluate postoperative patient satisfaction.ResultsThe operation time was 30-100 minutes (mean, 64.2 minutes). The total hospital stay was 2-12 days (mean, 4.5 days). Postoperative hospital stay was 1-4 days (mean, 1.8 days). All incisions healed by first intention after operation, and no surgery-related complications occurred. All patients were followed up 12-36 months (mean, 19.1 months). Lachman test and anterior drawer test were negative after operation. Lysholm score and IKDC score at 6 and 12 months after operation were significantly higher than those before operation, and at 12 months after operation were higher than those at 6 months after operation, the differences were significant (P<0.05). At last follow-up, according to five-point Likert scaling of patient satisfaction, 7 cases were very satisfied, 10 cases were relatively satisfied, and 1 case was general. The total patient satisfaction rate was 94.4% (17/18). MRI scan showed the good ligament tension.ConclusionUsing WALANT technique to repair partial ACL injuries under arthroscopy can retain the patient’s own ligament tissue to the maximum extent and achieve satisfactory short-term effectiveness.

    Release date:2021-03-26 07:36 Export PDF Favorites Scan
  • Local Warming and Lidocaine Pretreatment Reduces Injection Pain of Rocuronium

    目的 比较预注射利多卡因和局部加温缓解罗库溴铵注射痛效果。 方法 选取2011年3月-8月择期行腹腔镜下胆囊切除术的150例患者,按照完全随机的方法分为利多卡因组(L组)、局部加温组(W组)、对照组(C组),每组各50例患者。W组患者在留置针部位用Bair Hugger以40 °C加温1 min;L组患者用橡胶止血带在静脉近端加压直至静脉输液停止走行,推注1%利多卡因2 mL,1 min后松开止血带。随后3组患者均在2 s内静脉推注1 mL罗库溴铵注射液(含罗库溴铵10 mg)。观察在注射罗库溴铵前预先注射利多卡因及局部加温缓解注射痛的效果。 结果 罗库溴铵注射痛的发生率在W组、L组、C组中分别为62%、34%、82%。C组的疼痛发生率最高(P<0.05);W组的疼痛率高于L组(P<0.05);与W、L组相比,C组的重度疼痛率最高(P<0.05);L组的中、重度疼痛率低于W组(P<0.05)。 结论 预注射利多卡因和局部加温均能有效缓解罗库溴铵引起的注射痛,预注射利多卡因对于缓解罗库溴铵引起的注射痛更为有效。

    Release date:2016-09-08 09:14 Export PDF Favorites Scan
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