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自体富血小板纤维蛋白在鼓膜成形术中对移植物摄取的安全性和有效性:一项随机对照试验。

Safety and Efficacy of Autologous Platelet-rich Fibrin on Graft Uptake in Myringoplasty: A Randomized Controlled Trial.

作者信息

Nair Nithin Prakasan, Alexander Arun, Abhishekh B, Hegde Jyotirmay S, Ganesan Sivaraman, Saxena Sunil Kumar

机构信息

Department of ENT, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, Tamil Nadu, India.

出版信息

Int Arch Otorhinolaryngol. 2019 Jan;23(1):77-82. doi: 10.1055/s-0038-1649495. Epub 2018 May 9.

Abstract

Chronic suppurative otitis media is a common ailment in developing countries, and it generally presents with otorrhea and hearing loss. Different surgical procedures have been used to treat otitis media; among them is myringoplasty, which is a procedure that includes repair of the tympanic membrane. Platelet concentrates have been used widely in different types of wounds and are found to improve wound healing. Hence, the use of platelet-rich fibrin in myringoplasty will also improve the tympanic membrane healing.  To assess the safety and efficacy of autologous platelet-rich fibrin on graft uptake in myringoplasty.  Eighty-six patients were observed during the study period of two years. Forty-three patients in the study group underwent myringoplasty aided with platelet-rich fibrin, and 43 patients in the control group went through the same procedure but without the platelet-rich fibrin. The patients were observed for three months postoperatively by a blinded observer.  A total of 4.7% of the patients in the study group had postoperative infection, compared with a rate of 19% in the control group (  = 0.039). The graft uptake success rate was found to be 97.7% in the study group as compared with 81% in control group (  = 0.012). The results were found to be statistically significant.  Being autologous in nature, and by comparing the groups, platelet-rich fibrin is safe for patients. The postoperative graft uptake rate is better in cases in which platelet-rich fibrin was used. The postoperative infection rate was also lower in the same group.

摘要

慢性化脓性中耳炎在发展中国家是一种常见疾病,通常表现为耳漏和听力损失。不同的外科手术已被用于治疗中耳炎;其中包括鼓膜成形术,这是一种包括修复鼓膜的手术。血小板浓缩物已广泛应用于不同类型的伤口,并被发现可促进伤口愈合。因此,在鼓膜成形术中使用富血小板纤维蛋白也将改善鼓膜愈合。

评估自体富血小板纤维蛋白在鼓膜成形术中对移植物摄取的安全性和有效性。

在两年的研究期间观察了86例患者。研究组的43例患者接受了富血小板纤维蛋白辅助的鼓膜成形术,对照组的43例患者接受了相同的手术,但未使用富血小板纤维蛋白。由一名不知情的观察者对患者进行术后三个月的观察。

研究组共有4.7%的患者术后发生感染,而对照组的这一比例为19%(P = 0.039)。研究组的移植物摄取成功率为97.7%,而对照组为81%(P = 0.012)。结果具有统计学意义。

富血小板纤维蛋白本质上是自体的,通过比较两组,发现其对患者是安全的。使用富血小板纤维蛋白的病例术后移植物摄取率更高。同一组的术后感染率也更低。

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