切换至 "中华医学电子期刊资源库"
高级检索
中华神经创伤外科电子杂志

中华神经创伤外科电子杂志 ›› 2021, Vol. 07 ›› Issue (01) : 29 -32. doi: 10.3877/cma.j.issn.2095-9141.2021.01.007

所属专题： 文献；

颅脑损伤

快速止血器在模拟野战条件下头皮裂伤中的应用
徐广振1, 王兵2, 郭东良2, 朱伟杰1,†()   
  1. 1. 250031　济南，解放军第九六〇医院神经外科
    2. 100078　北京，北京鸿鹄高翔科技开发有限公司
  • 收稿日期:2021-01-07 出版日期:2021-02-15
  • 通信作者: 朱伟杰
  • 基金资助:
    军队医学科技青年培育项目(16QNP062)

Application of rapid hemostatic device in scalp laceration under simulated field conditions

Guangzhen Xu1, Bing Wang2, Dongliang Guo2, Weijie Zhu1,†()   

  1. 1. Department of Neurosurgery, 960th Hospital of PLA, Jinan 250031, China
    2. Beijing Honghugaoxiang Science and Technology Development Co., Ltd, Beijing 100078, China
  • Received:2021-01-07 Published:2021-02-15
  • Corresponding author: Weijie Zhu
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

徐广振, 王兵, 郭东良, 朱伟杰. 快速止血器在模拟野战条件下头皮裂伤中的应用[J]. 中华神经创伤外科电子杂志, 2021, 07(01): 29-32.

Guangzhen Xu, Bing Wang, Dongliang Guo, Weijie Zhu. Application of rapid hemostatic device in scalp laceration under simulated field conditions[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(01): 29-32.

目的

探索快速止血器在模拟战场条件下头皮裂伤止血中的应用。

方法

选取解放军第九六〇医院神经外科自2019年1月至2020年10月收治的颅脑外伤开颅手术患者55例，按照随机数字表法将患者分为对照组（28例）和试验组（27例）。对照组采用传统头皮夹钳夹取单个头皮夹方式，试验组采用快速头皮止血器上夹。比较2组患者的安置头皮夹时间、开颅过程中出血量、手术时间、术中头皮夹破裂率和弹飞率、术后头皮愈合等情况。

结果

试验组安置头皮夹时间及手术时间较对照组明显缩短，出血量少于对照组，差异具有统计学意义（P<0.05）；2组患者的术中头皮夹破裂率、弹飞率、术后头皮愈合情况差异无统计学意义（P>0.05）。

结论

快速头皮止血器可简化开颅操作、缩短开颅时间、减少开颅手术过程中出血量，并且不影响术后皮肤切缘恢复。

关键词: 头皮裂伤, 快速头皮止血器, 野战外科
Objective

To explore the application of rapid hemostatic device in scalp laceration hemostasis under simulated battlefield conditions.

Methods

A total of 55 patients with craniocerebral trauma admitted to Neurosurgery Department of 960th Hospital of PLA from January 2019 to October 2020 were selected and randomly divided into 2 groups by random number assignment method: control group (n=28) and treatment group (n=27). The control group were treated with traditional scalp clamps to clamp a single scalp clip, while the treatment group were treated with a fast scalp hemostatic device to clamp. The time of craniotomy, the amount of blood loss during craniotomy, the time of operation, the rate of rupture or bouncing of the skull clip during operation, and the postoperative scalp healing were compared between the two groups.

Results

The time of scalp clip placement and operation in the experimental group was significantly shorter than that in the control group, and the amount of bleeding was less than that in the control group, with statistical significance (P<0.05). There was no statistically significant difference in the rate of rupture and bouncing of the skull clip during operation, and the postoperative scalp healing between the two groups (P>0.05).

Conclusion

The rapid scalp hemostatic device can simplify craniotomy operation, shorten craniotomy time, reduce the amount of bleeding during craniotomy, and do not affect the recovery of postoperative skin incision margin.

Key words: Scalp laceration, Rapid scalp hemostatic device, Field surgery
图1 快速头皮止血器安置头皮夹的应用
表1 2组术中各项时间及术中出血量比较（±s）
组别 例数 安置头皮夹时间(min) 手术时间(min) 术中出血量(mL)
对照组 28 11.50±2.10 131.18±13.85 145.90±35.46
试验组 27 6.81±1.57 120.37±7.84 72.41±19.58
t值   9.346 3.543 9.464
P值   0.000 0.001 0.000
表2 2组患者术后愈合情况比较[例（%）]
组别 例数 甲级 乙级 丙级
对照组 28 20(71) 6(21) 2(7)
试验组 27 22(81) 4(15) 1(4)
χ2值     0.811  
P值     0.667  
表3 2组患者术中头皮夹稳定性情况比较[例（%）]
组别 头皮夹个数 破裂率 弹飞率
对照组 503 10(1.99) 8(1.59)
试验组 524 8(1.88) 7(1.65)
χ2值   0.222 0.067
P值   0.637 0.769
[1]
Rosa IP, Hirata SH, Enokihara MY, et al. A method using simple stitches around the safety margin for hemostasis in scalp surgery[J]. J Am Acad Dermatol, 2018, 78(2): e39-e40.
[2]
Tan EC, Peters JH, McKee JL, et al. The iTClamp in the management of prehospital haemorrhage[J]. Injury, 2016, 47(5): 1012-1015.
[3]
Arne BC. Management of scalp hemorrhage and lacerations[J]. J Spec Oper Med, 2012, 12(1): 11-16.
[4]
秦昊，宗兆文，刘良明,等.战现场单兵急救包配备需求分析及研制[J].华南国防医学杂志, 2016, 30(8): 523-525.
[5]
Frimpong P, Nguyen TTH, Nimatu ES, et al. Scalp injury management by a maxillofacial surgeon in a low-resource hospital[J]. Maxillofac Plast Reconstr Surg, 2020, 42(1): 39.
[6]
Ochs M, Chung W, Powers D. Trauma surgery[J]. J Oral Maxillofac Surg, 2017, 75(8s): e151-e194.
[7]
McKee JL, McKee IA, Ball CG, et al. The iTClamp in the treatment of prehospital craniomaxillofacial injury: a case series study[J]. J Inj Violence Res, 2019, 11(1): 29-34.
[8]
刘伟，李丽娟.外军卫勤系列研究(129)美军新版战术战伤救治指南及相关技术进展[J].人民军医, 2019, 62(8): 719-722.
[9]
Currie KB, Ross P, Collister P, et al. Analysis of scalp and forehead injuries in a level I trauma center[J]. J Craniofac Surg, 2017, 28(5): 1350-1353.
[10]
Varas-Meis E, Eiris N, Rodríguez-Prieto MA. Surgical staples for hemostasis during scalp surgery[J]. J Am Acad Dermatol, 2017, 76(5): e175-e176.
[11]
Basyuni S, Panayi A, Sharma V, et al. A missed scalp laceration causing avoidable sequelae[J]. Int J Surg Case Rep, 2016, 23: 61-64.
[12]
陈沛林，黄国豪，王伟金.新型头皮夹承载装置在头皮止血中的应用[J].中外医学研究, 2019, 17(27): 61-63.
[13]
Ozoilo KN, Amupitan I, Peter SD, et al. Experience in the management of the mass casualty from the January 2010 Jos crisis[J]. Niger J Clin Pract, 2016, 19(3): 364-367.
[14]
Daniel Y, Habas S, Malan L, et al. Tactical damage control resuscitation in austere military environments[J]. J R Army Med Corps, 2016, 162(6): 419-427.
[15]
Zacher MT, Högele AM, Hanschen M, et al. [General principles of wound management in emergency departments][J]. Anaesthesist, 2016, 65(4): 303-324.
[16]
Zhang YJ, Gao B, Liu XW. Topical and effective hemostatic medicines in the battlefield[J]. Int J Clin Exp Med, 2015, 8(1): 10-19.
[1] 雷权, 魏敦宏, 韦红梅, 是文辉, 刘江伟. 新疆军区特殊环境野战外科研究中心的构建与思考[J]. 中华诊断学电子杂志, 2020, 08(02): 103-106.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号