不同剂量碱性成纤维细胞生长因子治疗鼓膜创伤性穿孔的疗效比较  

Comparison of the Efficacy in the Treatment of Traumatic Tympanic Membrane Perforation Among Different Doses of Basic Fibroblast Growth Factor

作　　者：楼正才[1] 陈华英[1] 吴小洪[1] 

机构地区：[1]温州医科大学附属义乌医院耳鼻咽喉科,浙江省义乌市322000

出　　处：《中国全科医学》2016年第6期706-709,共4页Chinese General Practice

摘　　要：目的比较高剂量、低剂量碱性成纤维细胞生长因子（b FGF）治疗鼓膜创伤性穿孔的疗效。方法选取2012年7月—2014年2月温州医科大学附属义乌医院耳鼻咽喉科门、急诊收治的鼓膜创伤性穿孔患者168例为研究对象,根据初次接诊时鼓膜创伤性穿孔大小及接诊时间的先后顺序随机分为低剂量组85例和高剂量组83例。低剂量组给予重组牛b FGF滴眼液滴耳,1次/d,2-3滴/次（0.10-0.15 ml）;高剂量组给予重组牛b FGF滴眼液滴耳,1次/d,5-6滴/次（0.25-0.30 ml）。随访至鼓膜创伤性穿孔愈合或治疗3个月后,记录两组患者穿孔时间、脓性耳漏发生率、愈合率及愈合时间。结果治疗3个月后,168例患者中11例失访。低剂量组与高剂量组患者穿孔时间、愈合率比较,差异无统计学意义（P〉0.05）。高剂量组患者脓性耳漏发生率高于低剂量组,愈合时间长于低剂量组（P〉0.05）;高剂量组中穿孔、大穿孔患者脓性耳漏发生率高于低剂量组,愈合时间长于低剂量组（P〈0.05）。高剂量组15例继发脓性耳漏的中穿孔患者,13例（86.7%）愈合,平均愈合时间（16.4±4.7）d;13例继发脓性耳漏的大穿孔患者均愈合,平均愈合时间（15.1±5.3）d。结论每天持续小剂量重组牛b FGF滴眼液滴耳维持鼓膜潮湿环境足以引起鼓膜创伤性穿孔愈合,避免脓性耳漏;大剂量重组牛b FGF滴眼液滴耳引起的鼓膜水样环境反而引起脓性耳漏,延长愈合时间。Objective To compare the efficacy in the treatment of traumatic tympanic membrane perforation（ TMP）between low- dose and high- dose basic fibroblast growth factor（ b FGF）. Methods Enrolled 168 TMP patients who were admitted in to the outpatient emergency unit of the Department of Otorhinolaryngology of Yiwu Hospital Affiliated to Wenzhou Medical University from July 2012 to February 2014. According to the size of TMP in the first consultation and the sequence of consultation,the patients were divided into low- dose group（ n = 85） and high- dose group（ n = 83）. The low- dose group was administrated with recombinant bovine b FGF- containing eye drops into ear once per day and 2- 3 drops（ 0. 10- 0. 15 ml）per time; the high- dose group was administrated with recombinant bovine b FGF- containing eye drops into ear once per day and5- 6 drops（ 0. 25- 0. 30 ml） per time. The follow- up was conducted until the healing of TMP or three months later,during which we recorded the injury time,the incidence of purulent otorrhea,healing rate and healing time of patients. Results Three months later,11 patients were lost to follow- up. The two groups were not significantly different in the injury time and healing rate（ P〈0. 05）. The high- dose group had higher incidence of purulent otorrhea and longer healing time than the low- dose group（ P〈0. 05）. The two groups were not significantly different in the injury time and healing rate of patients with middle- size TMP and large- size TMP（ P〈0. 05）; the high- dose group had higher incidence of purulent otorrhea and longer healing time of middle- size TMP patients and large- size TMP patients than the low- dose group（ P〈0. 05）. In the high- dose group,there were 15 middle- size TMP patients with secondary purulent otorrhea and 13 patients that healed with an average healing time of（ 16. 4 ± 4. 7） d; there were 13 patients with purulent otorrhea that healed with an average healing time of（ 15. 1 ± 5. 3） d.Conclusion The daily admi

关 键 词：鼓膜穿孔 创伤 成纤维细胞生长因子 伤口愈合 治疗结果 

分 类 号：R764.29[医药卫生—耳鼻咽喉科]