ỨNG DỤNG VẬT LIỆU HỖ TRỢ CẦM MÁU CHỨA YẾU TỐ THROMBIN TRONG PHẪU THUẬT XUẤT HUYẾT NÃO TỰ PHÁT

Abstract

Objectives: Evaluating the rate of postoperative rebleeding following spontaneous intracerebral hemorrhage surgery using thrombin – containing hemostatic agent and establishing a protocol for the application of thrombin – containing hemostatic agents in spontaneous intracerebral hemorrhage surgery at Cho Ray Hospital. Methods: A descriptive retrospective study of 27 cases involving the application of thrombin – containing hemostatic agent in spontaneous intracerebral hemorrhage surgery at the Department of Neurosurgery, Cho Ray Hospital, from January 2024 to February 2025. Results: Epidemiology: the mean age was 50,1 + 13,8 years, with a male – to – female ratio of approximately 3,5 : 1. There were 23 cases with pre-existing hypertension (accounting for 85.2%). Preoperative clinical symptoms: regarding clinical symptoms, 25 cases had a glasgow coma scale score of 5 – 12 points (92,6%), 2 cases had a glasgow coma scale score of 13 points (7,4%), and no cases were below 5 points. Time to surgery: early surgery (within 48 hours) was performed in 21 cases (accounting for approximately 80%). Imaging characteristics: among the 27 cases of hemorrhage in the internal capsule – basal ganglia region, 4 cases had extension into the thalamus (14,8%), 8 cases extended to the cerebral lobe (29,6%), and 11 cases extended into the ventricles (40,7%). Postoperatively, there was 1 case of rebleeding (accounting for 3,7%), and no other abnormalities were recorded. Conclusions: The application of topical hemostatic agents containing thrombin in surgery for spontaneous intracerebral hemorrhage is safe and effective in reducing rebleeding rates, thereby potentially shortening hospital stays and reducing the economic burden on the healthcare system.