陈丽荣　窦春波 　李金超　高晓佩

[關键词]重组人表皮生长因子;组织瓣;口腔颌面部创伤性缺损畸形;生长因子

[中图分类号]R782.2    [文献标志码]A    [文章编号]1008-6455（2021）12-0111-05

rhEGF Combined with Tissue Flap to Repair Traumatic Oral and MaxilloFacial Defects

CHEN Li-rong1， DOU Chun-bo2， LI Jin-chao2， GAO Xiao-pei1

（1.Department of Prosthodontics; 2. Department of Oral and Maxillofacial Surgery， Dongfeng Stomatological Hospital Affiliated to Hubei University of Medicine， Shiyan 442001，Hubei，China）

Abstract： Objective  Analyze the effect of recombinant human epidermal growth factor （Recombinant human epidermal growth factor， rhEGF） combined with tissue flap to repair traumatic defect deformity of oral and maxillofacial region. Methods  From January 2017 to January 2020， 21 patients with traumatic oral and maxillofacial defects in our hospital were selected as the subjects. According to the random digital table method， 11 cases were divided into the combined group and 10 cases in the control treatment group. Control group patients were treated with tissue flap， combined group on the basis of control group rhEGF treatment. The expression levels of growth factor， facial function， pain， psychology， quality of life， clinical efficacy and satisfaction were compared between the two groups. Results The TNF-α、IL-1、IL-6 expression level in the combined group decreased compared with the control group （P<0.05）. The expression of VEGF、bFGF、EGF in the combined group increased compared with the control group （P<0.05）. The rate of facial nerve dysfunction in the combined group was lower than that in the control group （P>0.05）， and the facial disability index in the combined group was higher than that in the control group （P<0.05）. Compared with the control group， the pain and psychological score in the combined group decreased and the quality of life score increased （P<0.05）. Compared with the control group， the total effective rate of the combined group was higher （P>0.05）. Compared with the control group， the total satisfaction of the patients in the combined group was higher （P>0.05）. Conclusion  Combined application of rhEGF、 tissue flap in the repair of traumatic defects in oral and maxillofacial regions can significantly reduce local inflammation， increase the content of growth factors， promote the repair of defects， improve facial function， and improve the quality of life of patients. The application effect is ideal.

Key words： recombinant human epidermal growth factor; tissue flap; oral and maxillofacial traumatic defect; growth factor

口腔颌面部创伤性缺损畸形属于一种临床上较为常见的疾病，颌面部位置较为突出且暴露，较易出现创伤性损伤，不仅造成患者口腔颌面部外观异常，还在一定程度上对其心理、生活带来较大影响[1]。临床上多以止血、功能恢复为口腔颌面部创伤性缺损畸形的治疗原则，并在最大程度上促进缺损畸形的修复，恢复患者容貌。目前，随着社会经济、交通的不断发展，导致口腔颌面部创伤性缺损畸形的发生率呈逐年上升趋势，且患者对于缺损畸形和功能重建的期望度较高，给目前的治疗带来了挑战[2-3]。笔者科室采用rhEGF联合组织瓣修复口腔颌面部创伤性缺损畸形并分析其作用，以期为临床上口腔颌面部创伤性缺损畸形的修复提供参考。

1  资料和方法

1.1 一般资料：选取2017年1月-2020年1月笔者医院收治的21例口腔颌面部创伤性缺损畸形患者为研究对象，按照随机数字表法分为联合组11例和对照组10例。联合组：男6例，女5例，年龄25～41.5岁，平均年龄（30.67±5.12）岁;伤口长度4～12.6cm，平均伤口长度（8.00±2.15）cm。创伤缺损部位：唇部6例，颊部2例，下额3例。致伤原因：交通事故7例，坠落3例，切割1例;对照组：男5例，女5例;年龄25～42.9岁，平均年龄（31.02±5.26）岁;伤口长度3～12.5cm，平均伤口长度（7.89±2.20）cm。创伤缺损部位：唇部5例，颊部3例，下额2例。致伤原因：交通事故6例，坠落2例，切割2例。两组患者基本资料比较差异无统计学意义，患者家属均知情同意，且经医院伦理委员会批准。……