成纤维生长因子治疗创伤性鼓膜大穿孔的疗效研究

发布时间：2018-01-22 00:07

本文关键词： 成纤维细胞生长因子鼓膜穿孔创伤和损伤　出处：《中国全科医学》2014年08期 　论文类型：期刊论文

【摘要】：目的评估直接应用碱性重组牛成纤维生长因子(bFGF)治疗创伤性鼓膜大穿孔的疗效。方法选择2011年1月—2012年1月就诊于我院耳鼻咽喉科门诊的107例鼓膜穿孔面积超过鼓膜面积50%的创伤性鼓膜大穿孔患者,患者均在伤后14 d内就诊,按照就诊顺序分为3组:保守治疗组(n=36)、bFGF治疗组(n=35)、bFGF联合明胶海绵贴片组(联合治疗组,n=36)。随访观察3组的鼓膜愈合率、平均愈合时间、耳漏发生率及听力改善程度。结果随访3个月时,保守治疗组、bFGF治疗组和联合治疗组分别失访7、3、3例,共94例患者纳入疗效分析。bFGF治疗组、联合治疗组及保守治疗组的愈合率分别为100.0%(32/32)、97.0%(32/33)、55.2%(16/29),平均愈合时间分别为(11.1±1.5)、(11.1±2.3)、(46.3±8.7)d。与保守治疗组比较,bFGF治疗组和联合治疗组的愈合率高,平均愈合时间短(P0.05),bFGF治疗组和联合治疗组愈合率和平均愈合时间间差异无统计学意义(P0.05)。保守治疗组中有2例发生感染的穿孔无一例愈合;bFGF治疗组中有2例发生感染的穿孔分别在治疗17、14 d时闭合;联合治疗组中1例发生感染的穿孔经局部抗生素滴耳后在治疗11 d时闭合。随访期间,3组均未发生严重并发症。结论直接应用bFGF能提高创伤性鼓膜大穿孔愈合率,缩短平均愈合时间,且无严重并发症。
[Abstract]:Objective to evaluate the direct application of basic recombinant bovine fibroblast growth factor (BFGF). Methods from January 2011 to January 2012, 107 cases of traumatic tympanic membrane perforation were treated in our department of otolaryngology. The area of perforation of tympanic membrane was more than 50% of the total area of tympanic membrane. A patient with a large perforation of the membrane. All the patients were treated within 14 days after injury and were divided into 3 groups according to the order of treatment: conservative treatment group (n = 36) and bFGF group (n = 35). BFGF combined with gelatin sponge patch group (combined treatment group). The rate of tympanic membrane healing, the average healing time, the incidence of ear leakage and the degree of hearing improvement were observed after 3 months follow-up. 3 cases in the conservative treatment group and 3 cases in the combined treatment group were treated with bFGF. A total of 94 cases were included in the curative effect analysis. BFGF treatment group. The healing rates in the combined treatment group and the conservative treatment group were 100.0 / 32 / 32 / 97.0 and 32 / 33 / 55.2 / 29, respectively. The average healing time was 11.1 卤1.5 and 11.1 卤2.3 days, respectively, compared with the conservative treatment group. The healing rate of bFGF group and combined treatment group was high and the average healing time was short (P0.05). There was no significant difference in the healing rate and average healing time between the bFGF group and the combined treatment group (P 0.05). In the bFGF treatment group, 2 cases of infected perforation were closed on the 14th day after treatment. In the combined treatment group, one infected perforation was closed at 11 days after local antibiotic dripping. Conclusion the direct application of bFGF can improve the healing rate of large perforation of traumatic tympanic membrane, shorten the average healing time, and have no serious complications.
【作者单位】：浙江省义乌市中心医院耳鼻咽喉科;
【分类号】：R764.8
【正文快照】： 创伤性鼓膜穿孔是耳科常见病,可导致传导性耳聋、耳鸣及中耳感染。大多数创伤性鼓膜穿孔倾向于自然愈合,然而穿孔较大时愈合非常困难[1-3],临床对创伤性鼓膜大穿孔的治疗尚存在争论。一些学者建议及时行鼓膜成形术[4],也有学者主张行明胶海绵贴片+穿孔缘修复术[5]。然而,鼓膜

【参考文献】