《中国组织工程研究》 Chinese Journal of Tissue Engineering Research561·研究原著·覃文聘，女，1998年生，湖北省恩施土家族苗族自治州人，土家族，空军军医大学医疗系本科在读，主要从事神经损伤与修复研究。

通讯作者：黄景辉，副教授，解放军第四军医大学西京医院骨科，陕西省西安市 710032文献标识码:A投稿日期：2019-04-09 送审日期：2019-04-09 采用日期：2019-06-15 在线日期：2019-09-20Qin Wenpin, The Cadet Team 5 (Regiment), School of Basic Medicine, The Fourth Military Medical University, Xi’an 710032, Shaanxi Province, ChinaCorresponding author: Huang Jinghui, Associate professor, Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, Shanxi Province, China流体明胶Surgiflo TM与明胶海绵在腰椎融合手术中止血效果的对比覃文聘1，杨雨洁2，赵来赫2，石晓伟2，鹿 蕾3，杨鸿旭3，黄景辉2(1解放军第四军医大学基础医学院学员五大队，陕西省西安市 710032；2解放军第四军医大学西京医院骨科，陕西省西安市 710032；3军事口腔医学国家重点实验室，国家口腔疾病临床医学研究中心，陕西省口腔疾病国际联合研究中心，解放军第四军医大学口腔医院口腔解剖生理学教研室，陕西省西安市 710032) DOI:10.3969/j.issn.2095-4344.2209 ORCID: 0000-0002-0991-0591(覃文聘)文章快速阅读：文题释义：流体明胶Surgiflo TM ：是一种可吸收的止血明胶基质，是从猪皮中提取的明胶提取物，适用于在毛细血管、静脉和细小动脉等出血而依靠压迫、结扎或其他传统方法控制无效或不可行时的手术辅助止血(眼科手术除外)。

脊柱融合手术：是通过植骨和内固定等方式将原本活动的脊柱融合为一体的手术方式，在重建腰椎稳定中发挥着关键作用。

摘要背景：止血是脊柱外科术中最重要的手术环节，目前普遍应用的明胶海绵具有一定的效果，但止血时间长，止血效果不理想，需要探索新的止血方法。

目的：比较流体明胶Surgiflo TM 与普通明胶海绵在腰椎融合手术中的止血效果。

方法：纳入解放军第四军医大学西京医院2017年9至12月收治的98例腰椎融合手术患者，其中男52例，女46例，平均年龄54.32岁，所有患者均进行单节段L 4/5腰椎融合手术，其中48例应用流体明胶Surgiflo TM 进行术中止血，50例应用普通明胶海绵进行术中止血。

比较两组术中出血量、术后引流量、3 min 止血成功率、围术期血红蛋白变化等。

结果与结论：①流体明胶组手术时间短于普通明胶组[(105±26)，(118±32) min ，P < 0.05]，术中出血量、术后引流量少于普通明胶组[流体明胶组：(156±57)，(106±42) mL ；普通明胶组：(204±62)，(148±35) mL ，P < 0.05]，3 min 止血成功率高于普通明胶组(94%，80%，P < 0.05)，围术期血红蛋白变化量低于普通明胶组[(12.3±3.6)，(22.8±4.3) g/L ，P < 0.05]；②两组患者均未发生过敏反应、免疫排斥反应、术后延迟血肿等并发症；③结果表明，流体明胶Surgiflo TM 可显著减少腰椎融合手术的术中出血量及术后引流量，具有更好的止血效果。

关键词：脊柱手术；止血；流体明胶；明胶海绵；腰椎融合手术；手术时间；不良反应；出血 中图分类号：R459.9；R318.08；R619+1 基金资助：国家自然科学基金(81672148)，项目负责人：黄景辉Hemorrhage control of fluid gelatin Surgiflo TMversus gelatin sponge in lumbar spine fusion surgeryQin Wenpin 1, Yang Yujie 2, Zhao Laihe 2, Shi Xiaowei 2, Lu Lei 3, Yang Hongxu 3, Huang Jinghui 2 (1The Cadet Team 5 (Regiment), School of Basic Medicine, The Fourth Military Medical University, Xi’an 710032, Sha anxi Province, China; 2D epartment of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, Shanxi Province, China; 3State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Oral Anatomy and Physiology, School of Stomatology, The Fourth Military Medical University, Xi’an 710032, Shanxi Province, China )覃文聘，杨雨洁，赵来赫，石晓伟，鹿蕾，杨鸿旭，黄景辉. 流体明胶Surgiflo TM 与明胶海绵在腰椎融合手术中止血效果的对比[J]. 中国组织工程研究，2020，24(4):561-565. DOI:10.3969/j.issn.2095-4344.2209562AbstractBACKGROUND: Hemorrhage control has been an important issue in spine surgery. The widely used gelatin sponge is limited by its long-time bleeding control and poor hemorrhage control. Therefore, new techniques are needed to control bleeding in spine surgery.OBJRCTIVE: To compare the hemostatic effect of fluid gelatin Surgiflo TM with absorbable gelatin sponge in single level posterior lumbar fusion surgery.METHODS: Ninety-eight patients consisting of 52 males and 46 females, aged 54.32 years who received treatment between September 2017 and December 2017 in Xijing Hospital of The Fourth Military Medical University were included in this study. All patients underwent single-level L 4/5 lumbar fusion. Among them, 48 patients received intraoperative hemostasis with fluid gelatin SurgifloTM and 50 patients receivedintraoperative hemostasis with conventional gelatin sponge. Intraoperative bleeding volume, postoperative drainage volume, success rate of hemostasis in 3 minutes and changes of hemoglobin levels in perioperative period were compared between the two groups.RESULTS AND CONCLUSIONS: The operation time in the Surgiflo TM group was significantly shorter than that in the gelatin sponge group [(105±26) vs . (118±32) min, P < 0.05]. The amount of intraoperative blood loss and total amount of drainage were (156±57) mL and (106±42) mLin the Surgiflo TMgroup which were significantly lower than those in the gelatin sponge group [(204±62) mL, (148±35) mL, P < 0.05]. The successrate of hemostasis within 3 minutes in the Surgiflo TMgroup was significantly higher than that in the gelatin sponge group (94% vs. 80%, P < 0.05). The change in hemoglobin level during the perioperative period relative to pre-surgery level was significantly higher in the Surgiflo TM group was significantly lower than that in the gelatin sponge group [(12.3±3.6) vs . (22.8±4.3) g/L, P < 0.05]. No complications such as anaphylaxis, immune rejection, or delayed hematoma occurred in both groups. These results suggest that fluid gelatin Surgiflo TM can significantly reduce intraoperative blood loss and postoperative drainage volume in single-level lumbar fusion surgery and exhibit better hemostatic effects.Key words: spine surgery; hemorrhage control; fluid gelatin Surgiflo TM ; gelatin sponge; lumbar fusion surgery; operation time; adverse effect; bleedingFunding: the National Natural Science Foundation of China, No. 81672148 (to HJH)0 引言 Introduction近年来，脊柱外科手术尤其是腰椎融合手术呈逐年增加的趋势[1-2]。