血小板衍生的生長因子凝膠治療放療後的黏膜糜爛

Application of Platelet-Derived Growth Factor-BB Homodimers for Mucosal Erosion of Irradiated Patient

呂宜興(Yi-Shing Leu) ； 黃志銘(Chin-Ming Huang) ； 陳柏年(Bo-Lien Chen)

《台灣耳鼻喉頭頸外科雜誌》 41卷1期 (2006/02) Pp. 38-41

https://doi.org/10.6286/2006.41.1.38

摘要

臨床上公認影響傷口癒合最重要因素就是放射治療，一旦癌症病患的放射治療區域傷口癒合不良，目前能考慮的處理方式是使用抗生素以減少發炎、高壓氧以增加局部血液循環、甚至外科整型重建手術來修補。傷口癒合反應已經不屬於普通名詞，而是一群容易被破壞的酵素或因子依序出現的過程，這過程包括凝結、發炎、細胞間質合成及沉積、血管增生、纖維素增加、表皮增生、收縮及重新塑造，這些過程進展的速度由各種生長因子來調節，所以部分生長因子所萃取的藥物或許可以解決一些傷口癒合的問題。本文報告一65歲女性鼻咽癌患者接受放射治療超過25年，因為近日反覆大量鼻部出血，發現放射治療區血管擴張。在頭頸部核磁共振檢查排除腫瘤復發後，又擔心雷射或電燒會引起更大的麻煩，所以使用目前治療糖尿病肢體潰瘍的基因重組血小板衍生的生長因子藥物局部塗抹，每天一次，經過14天後病灶顯著改善，黏膜上的血管幾乎已經因纖維化而消失，再經過21天後，傷口全部癒合，故提出報告。

關鍵字

血小板衍生的生長因子 ； 血管擴張

並列摘要

Clinically, the most important factor that impairs wound healing is radiotherapy. There are several ways to deal this problem, including antibiotics, hyperbaric oxygen therapy and surgical reconstruction. Wound healing is no longer thought of in generic terms but indicates a series of components or processes that occur in sequence and are made up of coagulation, inflammation, matrix synthesis, deposition, angiogenesis, fibroplasias, epithelialization, contraction, and remodeling. These are regulated and processed by many and varied growth factors. Based on this, it is clear that growth factors may accelerate wound healing and ultimately help to solve some types of problems. A 65-year-old woman irradiated for nasopharyngeal carcinoma 25 years previously was bothered recently by intermittent epistaxis and blood-tinged sputum due to mucosal hemangiectasis over the nasal cavity and nasopharynx. The above conditions were refractory to conventional medical treatment without management by laser treatment or electrocauterization to prevent a bleeding disaster. The possibility of nasopharyngeal cancer recurrence was excluded after head and neck imaging. Human platelet-derived growth factor-BB homodimers gel, which is commonly used for the treatment of intractable ulcers in diabetic patient was applied to the hemagiectasia area once daily. The mucosal lesion had almost disappeared by 14 days and was cured by 21 days.

並列關鍵字

platelet derived growth factor ； hemangiectasia