Emrah EGEMEN, Ümit Akın DERE, Başak ÜNVER KOLUMAN, Yücel DOĞRUEL, Ahmet KOLUMAN, Batuhan BAKIRARAR, Nazlı ÇİL, Esin AVCI, Emine TURAL, Fatih YAKAR

Ankaferd Kanama Durdurucunun Beyin Parankiminde Hemostatik Etkisi: Deneysel Çalışma

Amaç: Hemostaz, ameliyatın başarısı için hayati bir aşamadır. Düşük maliyetli ve güvenilir bir ajan olan Ankaferd kanama durdurucu (AKD) pek çok ameliyatta kullanılmasına rağmen henüz kafa içi bölgede kullanıma sunulmamıştır. Bu çalışma, AKD’nun sitotoksik etkilerini ve memeli beyin parankimasında güvenlik profilini ortaya çıkarmayı amaçlamaktadır. Gereç ve Yöntemler: 30 Wistar Albino sıçan, 10 sıçandan oluşan üç gruba ayrıldı. Beyin parankim hasarına bağlı kanamalarda grup 1’de salin, grup 2’de %50 seyreltilmiş AKD ve grup 3’te %100 AKD ile hemostaz sağlandı. Ameliyat öncesi ve sakrifiye edilirken alınan kan örneklerinde ürotensin, Antitrombin III (AT3) ve fibrinojen çalışıldı. Ayrıca sıçanların sakrifiye edilmesinden sonra histolojik inceleme yapıldı ve yaralanma skorları değerlendirildi. Bulgular: Ameliyat öncesi alınan kan örneklerinde grup 2 ve 3’teki fibrinojen düzeyleri grup 1’e göre anlamlı derecede yüksekti. Her üç grupta da ameliyat öncesi döneme kıyasla sakrifikasyon sırasında ürotensin’de önemli bir artış vardı. (p=0,005) Grup 2’de hafif yaralanma, grup 3’te hafif yaralanma ve grup 1’de ciddi yaralanma istatistiksel olarak anlamlı derecede yüksekti. (p=0.005) Bu sonuçlar %50 seyreltilmiş AKD kullanımının güvenli olduğunu göstermektedir. Sonuç: Memeli beyin parankiminde ilk kez kullanılan AKD, sıçanlarda güvenli olarak değerlendirildi. Hemostatik matriks ajanlarla karşılaştırıldığında, güvenlik ve etkinliğe ek olarak, düşük maliyeti gelecekte klinik kullanımını artırabilir.

The Haemostatic Effects of Ankaferd Blood Stopper® on Mammalian Brain Parenchyma: An Experimental Study

Aim: Haemostasis is a vital stage for the success of the surgery. Although Ankaferd Blood Stopper (ABS), a low-cost and reliable agent, is used in many surgeries, it is not yet available for use in the intracranial area. This study aims to reveal ABS’s cytotoxic effects and safety profile in mammalian brain parenchyma. Material and Methods: 30 Wistar Albino rats were divided into three groups consisting of 10 rats. Haemostasis was achieved with saline in group 1, 50% diluted ABS in group 2, and 100% ABS in group 3 in bleeding caused by damage to the brain parenchyma. Urotensin, Antithrombin III (AT3) and fibrinogen were studied in blood samples taken before surgery and during sacrification. In addition, the histologic examination was performed after the sacrification of rats and injury scores were assessed. Results: Fibrinogen levels in groups 2 and 3 were significantly higher than group 1 in blood samples taken before surgery. There was a significant increase in urotensin during sacrification compared to the pre-surgical period in all three groups. (p=0.005) Slight injury in group 2, mild injury in group 3, and severe injury in group 1 were statistically significantly higher. (p=0.005) These results indicate that the use of 50% diluted ABS is safe. Conclusion: ABS, used for the first time in the mammalian brain parenchyma, was evaluated as safe in rats. Compared to haemostatic matrix agents, in addition to safety and efficacy, its low cost might increase its clinical use in the future.

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