重组牛碱性成纤维细胞生长因子外用凝胶联合耳内镜下软骨-软骨膜修补术治疗鼓膜大穿孔的临床研究

Clinical Study of Recombinant Bovine Basic Fibroblast Growth Factor External Gel Combined with Ear Endoscopic Cartilage-Perichondrium Repair in the Treatment of Large Tympanic Membrane Perforation

目的:探讨重组牛碱性成纤维细胞生长因子(bFGF)外用凝胶联合耳内镜下软骨-软骨膜修补术治疗鼓膜大穿孔的临床疗效。方法:选择2021年1月-2022年11月在中国人民解放军联勤保障部队第九八一医院接受诊治的鼓膜大穿孔患者120例。将患者根据随机数字表法分为对照组和研究组,各60例。对照组接受耳内镜下软骨-软骨膜修补术,研究组接受重组牛bFGF外用凝胶联合耳内镜下软骨-软骨膜修补术。对比两组愈合情况、听力情况[骨导听阈、气导听阈、气骨导差(A-B gap)]、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)]和并发症发生情况。结果:研究组的愈合例数高于对照组,平均愈合天数短于对照组(P<0.05)。研究组术后6个月骨导听阈、气导听阈、A-B gap低于对照组(P<0.05)。研究组术后3dTNF-α、IL-1β、IL-6低于对照组(P<0.05)。研究组的并发症发生率低于对照组(P<0.05)。结论:重组牛bFGF外用凝胶联合耳内镜下软骨-软骨膜修补术治疗鼓膜大穿孔,可缩短鼓膜愈合时间,改善患者听力,减轻炎症反应,安全性较好。

Objective:To investigate the clinical efficacy of recombinant bovine basic fibroblast growth factor(bFGF)external gel combined with ear endoscopic cartilage-perichondrium repair in the treatment of large tympanic membrane perforation.Methods:120 patients with large tympanic membrane perforation who were treated in the 981 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from January 2021 to November 2022 were selected.Patients were divided into control group and study group according to the random number table method,60 cases in each group.Control group received ear endoscopic cartilage-perichondrium repair,study group received recombinant bovine bFGF external gel combined with ear endoscopic cartilage-perichondrium repair.The healing condition,hearing condition[bone conduction hearing threshold,air conduction hearing threshold,air-bone gap(A-B gap)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6)]and complications were compared between two groups.Results:The number of healing cases in study group was higher than that in control group,and the average healing days were shorter than those in control group(P<0.05).The bone conduction hearing threshold,air conduction hearing threshold and A-B gap decreased in two groups at 6 months after operation in study group were was lower than those of control group(P<0.05).The levels of TNF-α,IL-1βand IL-6 in study group at 3 days after operation were was lower than those of control group(P<0.05).The incidence of complications in study group was lower than that in control group(P<0.05).Conclusion:Recombinant bovine bFGF external gel combine with ear endoscopic cartilage-perichondrium repair in the treatment of large tympanic membrane perforation,which can shorten the healing time of tympanic membrane,improve the hearing of patients,reduce the inflammatory reaction,and have good safety.