表皮生长因子对创伤性鼓膜穿孔愈合的临床研究  

Effect of Epidermal Growth Factor on Healing of Traumatic Tympanic Membrane Perforation

作　　者：吴小洪[1] 胡云星[1] 杨剑[1] 楼正才[1] 

机构地区：[1]浙江省义乌市中心医院耳鼻咽喉科,322000

出　　处：《中国全科医学》2010年第32期3677-3679,共3页Chinese General Practice

基　　金：浙江省2009年一般科技计划项目(2009C33097)

摘　　要：目的探讨表皮生长因子对创伤性鼓膜穿孔愈合的作用。方法 90例创伤性鼓膜穿孔患者按接诊时间顺序分为A、B、C三组,分别采用自然修复、单纯贴片修复及表皮生长因子贴片修复,比较三组患者穿孔愈合率及愈合时间,并动态观察修复过程穿孔边缘形态变化。结果随访2个月,A组26例定期随访,B组29例定期随访,C组27例定期随访。三组穿孔愈合率比较,差异无统计学意义(P>0.05)。三组穿孔愈合时间比较,差异有统计学意义(P<0.05)。A组愈合末期穿孔呈圆形或裂隙状,愈合鼓膜形态同周围鼓膜,纯音听阈(PTA)除3例外均恢复正常。B、C两组愈合末期穿孔呈圆形、裂隙状及不规则,愈合鼓膜充血肿胀、形态增厚与正常鼓膜有明显界限,3～7d后恢复正常。愈合时PTA(12±7)dB,10～30d后听力恢复正常。结论创伤性鼓膜穿孔贴膜修复不增加愈合率,可缩短穿孔愈合时间,但贴膜时局部应用表皮生长因子对缩短穿孔愈合时间作用不明显。Objective To explore the effect of epidermal growth factor on healing of traumatic tympanic membrane perforation.Methods Ninety patients with traumatic tympanic membrane perforation were divided,according to visiting time,into groups A,B,C,receiving natural restoration,simple patch repair,epidermal growth factor patch repair,respectively.The healing rates and time were compared between 3 groups and the morphological changes of perforated edge observed during repair process.Results The follow-up lasted 2 months,and 26 of group A,29 of group B and 27 of group C were followed up regularly.There was not significant difference in healing rate between 3 groups（P 0.05）,but there was in healing time（P〈0.05）.The perforation was round or slit-shaped,the healed tympanic membrane became the same as the surrounding and pure tone audiometry（PTA）returned to normal except 3 patients in group A at end of healing,and in groups B,C the perforation was round,slit-shaped and irregular,tympanic membrane red swelling,form thickened with obvious limits with normal tympanic membrane,and returned to normal after days 3,7.PTA was（12±7）dB when healing.Hearing came back to normal after days 10～30.Conclusion Patch repair can shorten the healing time of perforation,and local application of epidermal growth factor does not have obvious effect in shortening healing time.

关 键 词：鼓膜穿孔 创伤和损伤 表皮生长因子 

分 类 号：R764.83[医药卫生—耳鼻咽喉科]