重组人表皮生长因子对鼻-鼻窦炎患者鼻内镜术后创面上皮化的影响

目的　探讨重组人表皮生长因子（recombinant human epidermal growth factor，rhEGF）对慢性鼻-鼻窦炎（CRS）患者鼻内镜术后创面上皮化的影响。方法　选择110例CRS行双侧鼻内镜手术患者，对照组（右侧鼻腔）行鼻腔冲洗以及类固醇激素喷鼻，实验组（左侧鼻腔）加用rhEGF喷鼻，在术后2周、4周、3个月、6个月鼻内镜检查评估鼻腔黏膜情况及主观症状的视觉模拟量表（visual analogue scale，VAS）评分，比较鼻腔黏膜情况、完全上皮化比例、主观症状的VAS评分。结果　术后2周实验组鼻腔黏膜情况优于对照组（P＜0.05），但主观症状VAS评分无明显差异（P >0.05）；术后4周及3个月时实验组鼻腔黏膜情况、上皮化比例以及主观症状VAS评分均优于对照组（P＜0.05）；术后6个月时则无差异（P >0.05）。结论　CRS患者鼻内镜术后用rhEGF喷鼻，可缩短术后上皮化时间、改善鼻腔黏膜情况及患者主观症状，值得临床应用。

Effects of recombinant human epidermal growth factor on wound healing after endoscopic sinus surgery

OBJECTIVE To investigate the effects of recombinant human epidermal growth factor (rhEGF) on wound healing of chronic sinusitis patients after functional endoscopic sinus surgery. METHODS A total of 110 patients with chronic sinusitis underwent functional endoscopic sinus surgery with both sides of their nose. The right side of their nasal cavity (control group) treated by nasal irrigation and steroid nasal spray, the left side of their nasal cavity (study group) treated by nasal irrigation and the nasal spray of steroid hormones and rhEGF. Surgical effect was evaluated under nasal endoscope at 2, 4, 12 and 24 weeks after surgery, while subjective symptom was evaluated depending on visual analogue scale (VAS). Both the score of endoscopic examination and VAS, also the rates of epithelization of the two groups were compared. RESULTS The score of endoscopic examination of the study group at 2 weeks after surgery was better than that of the control group, which had statistical significance, while the score of VAS had no statistical difference. The score of endoscopic examination and VAS, the rate of epithelization in study group at 4 and 12 weeks after surgery were better than those in control group, and the difference was statistically significant, but they were no statistical difference at 24 weeks after surgery. CONCLUSION The using of rhEGF nasal spray on chronic sinusitis patients with functional endoscopic sinus surgery can shorten the time of epithelization, improve the situation of nasal mucosa and patients' subjective symptoms, it is worthy of clinical application.