成纤维生长因子治疗创伤性鼓膜大穿孔的疗效研究  

Effects of Fibroblast Growth Factor in Large Perforation of Tympanic Membrane

作　　者：陈华英[1] 吴小洪[1] 杨剑[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》2014年第8期947-949,共3页Chinese General Practice

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(P<0.05),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(P>0.05)。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。Objective To evaluate the effects of recombinant bovine basic fibroblast growth factor（bFGF） in treatment of large tympanic membrane perforation（TMP）.Methods From January 2011 to January 2012,a total of 107 large TMP patients（over 50% TMP area） visiting this hospital within 14 d after injury were divided,according to visiting order,into groups A（given conservative treatment,n=36）,B（given bFGF treatment,n=35）,C（given bFGF treatment combined with gelatin sponge plaster,n=36）.The healing rate,mean healing time,incidence of otorrhea and hearing improvement were observed.Results In 3-month follow-up,7 patients of group A,3 of group B,3 of group C were lost to follow up.Totally 94 patients were enrolled into effective analysis.The healing rates of groups B,C,A were 100.0%（32/32）,97.0%（32/33）,55.2%（16/29）,respectively,and the mean healing time（11.1 ± 1.5）d,（11.1±2.3）d,（46.3±8.7）d,respectively.The healing rate were higher,mean healing time shorter in groups B,C than in group A（P＜0.05）,there was no difference in healing rate,mean healing time between groups B,C（P＞0.05）.Two patients of group A had infection perforation（IP） and none healed,2 of group B had IP and closed on days 17,14 of treatment,1 of group C had IP and closed on days 11 of topical antibiotic treatment.During the follow-up,no serious complications happened in the three groups.Conclusion Direct application of bFGF can improve the healing rate of large TMPs and shorten the closure time without complications.

关 键 词：成纤维细胞生长因子 鼓膜穿孔 创伤和损伤 

分 类 号：R764.8[医药卫生—耳鼻咽喉科]