耳内镜下重组牛碱性成纤维细胞生长因子治疗外伤性鼓膜穿孔

The therapeutic effect of recombinant bovine basic fibroblast growth factor under otoscopy in the treatment of traumatic tympanic membrane perforation

目的探讨耳内镜下重组牛碱性成纤维细胞生长因子(rb-bFGF)治疗外伤性鼓膜穿孔的疗效。方法选择浙江省武义县第一人民医院2021年12月~2023年12月收治的外伤性鼓膜穿孔患者84例,采用随机数字表法分为传统鼓膜修复组和rb-bFGF组,每组42例。传统鼓膜修复组在穿孔处覆盖一层明胶海绵进行传统鼓膜修复;rb-bFGF组于耳内镜下取rb-bFGF适量后均匀涂抹于穿孔表面,然后覆盖明胶海绵,换药3天/次直至穿孔愈合。两组14天后进行疗效评价。结果(1)rb-bFGF组总有效率(88.09%)高于传统鼓膜修复组(57.14%)(P<0.01),rb-bFGF组穿孔愈合时间少于传统鼓膜修复组(P<0.01);(2)rb-bFGF组高频听阈、气骨导差均低于传统鼓膜修复组(P<0.01);(3)rb-bFGF组各并发症发生率均低于传统鼓膜修复组(P<0.05)。结论耳内镜技术与rb-bFGF的联合应用为外伤性鼓膜穿孔的治疗提供了新的思路和方法,具有较好的临床价值和广泛的应用前景。

Objective To investigate the therapeutic effect of recombinant bovine basic fibroblast growth factor(rb-bFGF)under otoscopy in the treatment of traumatic tympanic membrane perforation.Method 84 patients with traumatic tympanic membrane perforation admitted to the First People’s Hospital of Wuyi County,Zhejiang Province from December 2021 to December 2023 were selected.Using the random number table method,42 cases were divided into the traditional tympanic membrane repair group and the rb-bFGF group.The traditional tympanic membrane repair group covers the perforation with a layer of gelatin sponge for traditional tympanic membrane repair;The rb-bFGF group took an appropriate amount of rb-bFGF under otoscopy and evenly applied it to the perforated surface,then covered it with gelatin sponge.The dressing was changed every 3 days until the perforation healed.Two groups will undergo efficacy evaluation after 14 days.Result(1)The total effective rate of the rb-bFGF group(88.09%)was higher than that of the traditional tympanic membrane repair group(57.14%)(P<0.01),and the perforation healing time of the rb-bFGF group was shorter than that of the traditional tympanic membrane repair group(P<0.01);(2)The high-frequency hearing threshold and air bone conduction difference in the rb-bFGF group were lower than those in the traditional tympanic membrane repair group(P<0.01);(3)There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion The combined application of otoscopy technology and rb-bFGF provides a new approach and method for the treatment of traumatic tympanic membrane perforation,with good clinical value and broad application prospects.