重组人表皮生长因子及碱性成纤维细胞生长因子联合应用促进内镜鼻窦手术后术腔创面上皮化的疗效观察

Combined application of recombinant human epidermal growth factor and basic fibroblast growth factor after endoscopic sinus surgery

目的观察rhEGF凝胶及bFGF滴眼液联合应用对鼻内窥镜鼻窦相关手术后的术腔创面黏膜上皮化的效果。方法对30例(60侧)经鼻内镜全鼻窦开放术患者进行同体对照观察,左侧为观察组,鼻窦术后每周在鼻内镜下作一次详尽术腔清理,于术腔置放rhEGF凝胶及bFGF滴眼液,混合抗生素和地塞米松的明胶海绵;右侧为对照组鼻窦每天使用鼻腔冲洗器自行冲洗鼻腔,鼻内使用局部类固醇激素,每周作鼻内镜下的术腔清理1次。连续内镜随访12周,观察双侧术腔上皮化过程。结果观察组治愈(28例)93.33%,好转(2例)6.67%,平均上皮化时间4周;对照组治愈(24例)80%,好转(6例)20%,平均上皮化时间9周,平均上皮化时间差异有统计学意义(P<0.01)。结论鼻内窥镜鼻窦手术后联合应用rhEGF及bFGF可以促进术腔上皮化,显著缩短上皮化时间,治疗效果好。

Objective To observe the clinical effect of combined application of （recombinant human epidermal growth factor, rhEGF） and （basic fibroblast growth faetor,bFGF） after endoscopic sinus surgery. Methods Thirty patients （60 sides） were observed, in which all sinuses （maxillary, frontal, ethmoid and sphenoid） were operated on by endoscopic sinus surgery. For the purpose of homobody control study, the left nasal side was used as rhEGF and bFGF group, and right side contrast group. The patients were followed-up for 12 weeks. Results In rhEGF and bFGF groups, the curative rate was 93.33% , improvement rate 6.67% , and average time of epithelialization was 4 weeks. In contrast groups, the curative rate was 80%, improvement rate 20%, and average time of epithelialization was 9 weeks. It was distinct that in rhEGF and bFGF group, the epithelialization time was shorter than that in contrast group. Conclusions Combined use of rhEGF and bFGFcan effectively promote the process of epithelization in sinusal cavity following endoscopic surgery.