合成α-氰基丙烯酸正丁酯医用胶用于肝脏止血

合成α-氰基丙烯酸正丁酯医用胶用于肝脏止血 张  飞1，赵  君2，孟兴凯3，李剑锋2 (1内蒙古自治区人民医院普外科，内蒙古自治区呼和浩特市 010020；2内蒙古医科大学第二附属医院康复科，内蒙古自治区呼和浩特市 010050；3内蒙古医科大学附属医院普外科，内蒙古自治区呼和浩特市 010010) 引用本文：张飞，赵君，孟兴凯，李剑锋. 合成α-氰基丙烯酸正丁酯医用胶用于肝脏止血[J].中国组织 工程 路基工程安全技术交底工程项目施工成本控制工程量增项单年度零星工程技术标正投影法基本原理 研究，2016，20(47):7112-7118. DOI: 10.3969/j.issn.2095-4344.2016.47.017    ORCID: 0000-0002-2065-8147(张飞) 文章快速阅读： 改性医用胶特性及动物实验验证 张飞，男，内蒙古自治区乌兰察布市人，汉族，硕士，主治医师，主要从事普通外科方面的研究。 通讯作者：李剑锋，博士，副主任医师，内蒙古医科大学第二附属医院康复科，内蒙古自治区呼和浩特市 010050 中图分类号:R318 文献标识码:B 文章编号:2095-4344 (2016)47-07112-07 稿件接受：2016-10-22 筛选表面活性剂 可吸收线+明胶海绵 α-氰基丙烯酸酯医用凝胶 合成α-氰基丙烯酸正丁酯 兔肝切口实验 综合分析 兔肝创面实验 新合成医用凝胶 结论 文题释义：表面活性剂：表面活性剂的选取是一种含有多个醚键的聚合物，它对人体无毒副作用，既有亲水基团，同时又能与胶黏剂发生交联反应，因此，可以使胶黏剂更好的在湿润的创面黏合止血，避免了目前市场上医用胶亲水性差，止血效果不理想的缺点。α-氰基丙烯酸酯：是众多化学合成医用黏合剂之一，因其自身突出的优点被广泛应用于临床。它的主要成分是长链酯单体，之所以能在瞬间发挥其强黏结作用，是因为迅速发生了阴离子聚合。因该类黏合的a-位碳原子上含有电负性极强的基团如-CN和-COOR，产生诱导效应，β-位的碳原子有很强的吸电性，在微量阴离子存在下就能产生瞬间聚合反应，同时使聚合体形成多极性中心，为与黏结对象产生界面黏结力提供了条件，因此，α-氰基丙烯酸酯类具备了迅速胶接生物组织的特殊结构。 摘要背景：目前医用胶主要分化学合成医用胶及生物医用胶，化学合成医用胶主要成分为α-氰基丙烯酸酯，亲水性差，易形成胶痂脱落，止血不彻底。目的：合成α-氰基丙烯酸正丁酯并改进其黏结效果，通过白兔肝脏止血实验验证其改性后的止血、黏接效果等相关性能。  方法 快递客服问题件处理详细方法山木方法pdf计算方法pdf华与华方法下载八字理论方法下载 ：① 材料 关于××同志的政审材料调查表环保先进个人材料国家普通话测试材料农民专业合作社注销四查四问剖析材料 改良：制得α-氰基丙烯酸酯单体，通过红外波谱和气象色谱分析其组成和含量，合成α-氰基丙烯酸正丁酯。选用月桂酰肌氨酸钠作为表面活性剂，改进α-氰基丙烯酸正丁酯与组织脏器的结合效果，使其亲水性增强；②兔肝脏切口止血实验：分为3组，对照组在可吸收线缝合止血后覆盖明胶海绵，α-氰基丙烯酸酯医用胶组涂抹α-氰基丙烯酸酯医用胶，α-氰基丙烯酸正丁酯组涂抹合成及改性后的医用胶，在手术20 min内记录肝出血量和出血时间；③兔肝脏断面止血实验：分成2组，α-氰基丙烯酸正丁酯组在肝创面涂抹表面活性剂后，再涂合成的α-氰基丙烯酸正丁酯；α-氰基丙烯酸酯创面涂抹α-氰基丙烯酸酯医用胶。术后1，10和20 d通过肉眼观察肝创面胶层变化、与大网膜黏连情况等，再通过苏木精-伊红染色观察组织学变化。结果与结论：①改性后的α-氰基丙烯酸正丁酯医用胶有很好的黏结性，通过红外波谱和气象色谱分析，主要成分为α-氰基丙烯酸正丁酯，纯度为84.56%，其余含量较多的为反应物及生成的副产品，为8.2%和3.3%；②通过对兔肝脏切面出血量和出血时间比较，改性后的医用胶在出血量和出血时间上明显少于对照组(P < 0.01)，与α-氰基丙烯酸酯医用胶组差异无显著性意义(P > 0.05)；③改性后的医用胶胶层与肝创面结合更紧密，在术后20 d完全吸收，且未见到不良反应；④结果提示，改性后的α-氰基丙烯酸正丁酯医用胶黏接效果优于常规针线缝合，胶膜不易脱落，止血较彻底，无不良反应。 Zhang Fei, Master, Attending physician, Department of General Surgery, Inner Mongolia People’s Hospital, Hohhot 010020, Inner Mongolia Autonomous Region, China Corresponding author: Li Jian-feng, M.D., Associate chief physician, Rehabilitation Department, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China 关键词： 生物材料；材料相容性；改良；α-氰基丙烯酸正丁酯；α-氰基丙烯酸酯；肝脏止血；内蒙古自治区自然科学基金 主题词：生物相容性材料；止血；明胶海绵，吸收性；组织工程基金资助： 内蒙古自治区自然科学基金面上项目(2015MS0898) A chemosynthetic medical adhesive containing alpha-N butyl cyanoacrylate for liver hemostasis Zhang Fei1, Zhao Jun2, Meng Xing-kai3, Li Jian-feng2 (1Department of General Surgery, Inner Mongolia People’s Hospital, Hohhot 010020, Inner Mongolia Autonomous Region, China; 2Rehabilitation Department, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China; 3Department of General Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China) Abstract BACKGROUND: There are chemosynthetic and biological medical adhesives, and the former mainly composed by cyanoacrylate, holds poor hydrophilicity and is easy to break off, thereby achieving unsatisfactory hemostatic effect. OBJECTIVE: To evaluate the hemostatic and adhesion effect of the modified α-N butyl cyanoacrylate (NBCA) by the hemostatic test in white rabbit livers. METHODS: Material imprvement: cyanoacrylate monomer was prepared and its components and contents were analyzed by infrared spectrum and gas chromatograph. Sodium lauroyl sarcosinate was used as surfactant to improve the cohesive force between NBCA and tissues and increase the hydrophility. Hemostatic test in the liver incision: the liver incision of rabbits in three groups were sewn with absorbable suture and then covered with gelatin sponge (control group), cyanoacrylate and NBCA medical adhesives, respectively. Blood loss and bleeding time were recorded within 20 minutes. Hemostatic test in the liver section: the liver sections in two groups were smeared with surfactant plus NBCA and cyanoacrylate, respectively. The gross appearance of wound and its adherence to the omentum majus, as well as the histological changes by hematoxylin-eosin staining were observed at 1, 10 and 20 days postoperatively. RSULTS AND CONCLUSIPON: The adhesiveness of NBCA medical adhesive was excellent. Infrared spectrum and gas chromatograph found that the main component was NBCA up to 84.56%, with 8.2% reactants and 3.3% byproducts. The modified NBCA medical adhesive significantly decreased the blood loss and bleeding time compared with the control group (P < 0.01), and did not significantly differ from the cyanoacrylate (P > 0.05). In addition, the modificed NBCA adhered more firmly to the wound, and was absorbed completely at 20 days postoperatively, showing no adverse reaction. These results suggest that NBCA is better and more stable than gelatin sponge, and exerts overt hemostatic effect causing no adverse reaction. Subject headings: Biocompatible Materials; Hemostasis; Gelatin Sponge, Absorbable; Tissue Engineering