富血小板纤维蛋白膜片修复上颌窦瘘的临床研究

目的:观察自体富血小板纤维蛋白(Platelet-rich fibrin,PRF)膜片修补口腔上颌窦瘘的临床疗效。方法:选取解放军第425医院疗养区眼耳鼻喉科2010年4月到2013年4月间24例上颌窦瘘患者,采用随机分组,其中A组12例患者各采静脉血20 mL制备PRF膜片修补上颌窦瘘,另外B组12例患者采用组织瓣法修补上颌窦瘘,比较两组患者的伤口一期愈合成功率以及6-12月后随访预后并进行统计学分析。结果:PRF膜片修补组手术均获得成功,而组织瓣修补组中采用带蒂颚粘膜瓣有1例失败,两组间一期愈合成功率无显著差异(P=0.755),随访发现颊侧黏骨膜瓣修补的患者术后口腔前庭沟均有不同程度变浅,而其它修补方法术后前庭沟无明显异常。结论:自体PRF膜片制备简单,用其修补上颌窦瘘效果确切,手术简单,并发症少,可应用于临床实践。

Clinical Research on the Application of Platelet-Rich Fibrin Membrane in the Repair of Oroantral Fistula

Objective:To observe the clinical effect of autologous Platelet-rich fibrin (PRF) membrane on the repair of oroantral fistula.Methods:There were 24 patients enrolled in this clinical study fromApril 2010 to April 2013 in the Department of Ophthalmology and Otolaryngology, Convalescent District, 425th Hospital of PLA, which were randomly divided into two groups: GroupA (12 cases): repairing oroantral fistula with PRF membrane prepared by 20 ml autologous venous blood; Group B (12 cases): repairing oroantral fistula with tissue flaps. The rate of primary healing and prognosis during 6 months to one year of follow-up was compared.Results:There was 1 case with pedicle palatal mucosal flap in Group B failed and all the cases were successful in Group A. There was no statistical significance in the rate of primary healing (P=0.755). However, the oral vestibular sulcus with cheek flap repair was shallower than before in varying degree in follow-up.Conclusion:It is effective to use the autologous PRF membrane to repair oroantral fistula and the method is simple and feasible with fewer complications in clinical practices.