本文選題：殼聚糖透明質酸復合 + 阿里斯泰可��； 參考：《暨南大學》2010年碩士論文

【摘要】： 目的： 1.探討殼聚糖透明質酸復合止血粉及阿里斯泰可(Arista)對正常鼻粘膜影響。 2.探討殼聚糖透明質酸復合止血粉在內鏡鼻竇手術(endoscopic sinus surgery,ESS)術后止血效果及臨床應用的可行性。 方法： 將24只新西蘭白兔分成三組,第一組8只,鼻腔未作創(chuàng)面,實驗組及對照組各4只,實驗組予殼聚糖透明質酸復合(chitosan-hyaluronic acid composite)止血粉,對照組予Arista止血粉噴頜鼻甲,第3天取頜鼻甲粘膜行光鏡及掃描電鏡觀察；第二組8只,實驗組及對照組各4只,均予頜鼻甲造創(chuàng)面,實驗組予噴殼聚糖透明質酸復合止血粉,對照組予Merocel填塞,第3天處死全部白兔取頜鼻甲粘膜行光鏡及掃描電鏡觀察；第三組8只,雙側頜鼻甲造創(chuàng)面后,隨機選擇一側鼻腔使用殼聚糖透明質酸復合止血粉,對側使用Arista止血粉。并立即鼻孔棉條填塞,計算失血量。第3天、7天及第14天內窺鏡下觀察材料降解情況并評分。第7天,第14天各處死4只白兔時取鼻腔分泌物行細菌培養(yǎng)及頜鼻甲粘膜行光鏡觀察。 結果： 第一組,光鏡及掃描電鏡下實驗組及對照組粘膜與正常粘膜無明顯區(qū)別；第二組,實驗組光鏡下,粘膜輕度充血、水腫,炎癥細胞少許侵潤；掃描電鏡下粘膜未見異常；對照組光鏡下,粘膜充血、水腫,炎癥細胞侵潤,電鏡下纖毛倒伏,有明顯壓迫痕跡。第三分組,C.H.complex及Arista止血效果差別無統(tǒng)計學意義(P＞0.05)；3及7天的材料降解分析C.H.complex降解速度均比Arista慢.(P＜0.05),7天、14天光鏡下實驗組炎癥反應較Arista重。細菌培養(yǎng)提示,在第7天,C.H.complex細菌生長數(shù)量及菌種比Arista旺盛,第14天兩組細菌生長數(shù)量及菌種趨近相同。 結論： 1、殼聚糖透明質酸復合止血粉及Arista對正常鼻粘膜無負面影響；2、Merocel對粘膜有較明顯的負面影響；3、殼聚糖透明質酸復合止血粉止血效果與Arista相當；4、殼聚糖透明質酸復合止血粉降解速度慢,可引起粘膜炎癥反應；5、殼聚糖有可能成一種新的鼻腔非填塞可降解止血材料。
[Abstract]:Objective: 1. To investigate the effects of chitosan hyaluronic acid compound hemostatic powder and Arista on normal nasal mucosa. 2. To investigate the hemostatic effect and clinical application of chitosan hyaluronic acid combined with hemostatic powder in endoscopic sinus surgeryen (ESS). Methods: 24 New Zealand white rabbits were divided into three groups: the first group (n = 8) had no nasal wound, the experimental group (n = 4) and the control group (n = 4) were treated with chitosan hyaluronic acid compositeite. The control group was treated with Arista hemostatic powder. On the 3rd day, the mucosa of the mandibular turbinate was observed by light microscope and scanning electron microscope, the second group (n = 8), the experimental group (n = 4) and the control group (n = 4) were treated with maxillary turbinostomy, the experimental group were treated with chitosan hyaluronic acid compound hemostatic powder, the control group was filled with Merocel. On the 3rd day, all the rabbits were killed for light microscope and scanning electron microscope observation, and 8 rabbits in the third group were randomly selected to use chitosan hyaluronic acid compound hemostatic powder and Arista hemostatic powder in one side of nasal cavity after bilateral maxillary turbinostomy. And immediately the nostril cotton stuffing to calculate the amount of blood loss. The degradation of the material was observed under endoscope on day 3 and day 14. On the 7th and 14th day, the nasal secretion was taken from 4 rabbits and the mucous membrane of maxillary turbinate was observed under light microscope. Results: In the first group, there was no significant difference between the mucous membrane of the experimental group and the control group under light microscope and scanning electron microscope, while in the second group, there was mild congestion, edema and a little infiltration of inflammatory cells under the light microscope in the experimental group, and no abnormal mucous membrane was found under the scanning electron microscope. In the control group, hyperemia, edema and infiltration of inflammatory cells were observed under light microscope. There was no significant difference in hemostatic effect between C. H. complex and Arista in the third group. The degradation rate of C.H.complex was slower than that of Arista on day 3 and day 7. The inflammatory reaction of experimental group was more serious than that of Arista under light microscope for 14 days under light microscope. The results showed that the number and species of C. H. complex bacteria were stronger than that of Arista on the 7th day, and the growth numbers and strains of the two groups were the same on the 14th day. Conclusion: 1. Chitosan hyaluronic acid compound hemostatic powder and Arista had no negative effect on normal nasal mucosa. The chitosan hyaluronic acid compound hemostatic powder had the same hemostatic effect as Arista and chitosan hyaluronic acid compound. The rate of degradation of hemostatic powder is slow, Chitosan may become a new non-tamponade biodegradable hemostatic material.
【學位授予單位】：暨南大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R765

【引證文獻】

相關期刊論文 前1條

1 蘆業(yè)蓮;;氣囊填塞止血法在鼻出血治療中的應用[J];中國衛(wèi)生產(chǎn)業(yè);2013年05期

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本文編號：1868276