丝裂霉素C在泪囊鼻腔吻合术中的应用效果

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目的:评估应用丝裂霉素C在泪囊鼻腔吻合术中治疗慢性泪囊炎的效果。方法:回顾分析解放军第988医院2013年12月至2018年12月鼻内镜泪囊鼻腔吻合术40例(45眼)的临床资料。所有患者分为两组:治疗组,21例(22眼)术中在吻合口处贴敷丝裂霉素C棉片5分钟;对照组,19例(23眼)术中不贴敷丝裂霉素C棉片。随访6个月。对两组治疗效果进行观察比较。结果:治疗组治愈19眼,好转2眼,无效(复发)1眼,优于对照组的治愈11眼,好转4眼,无效(复发)8眼。两组治愈率相比有统计学意义(n χ2=4.67,n P=0.032)。治疗组术中出血(35±10)ml,少于对照组的(40±15)ml(n t=2.096,n P=0.019)。治疗组手术时间(45±12)分钟与对照组(42±11)分钟相比无统计学意义(n t=1.548,n P=0.065)。治疗组泪囊鼻腔吻合口形成时间短于对照组(n t=3.354,n P=0.001)。治疗组术后吻合口闭合仅见1眼(4.55%,1/22),少于对照组的8眼(34.78%,8/23)(n χ2=4.670,n P=0.032)。n 结论:应用丝裂霉素C在鼻内镜下泪囊鼻腔吻合术术中慢性泪囊炎治疗可明显减少复发率。“,”Objective:To evaluate the application effect of mitomycin C in dacryocystorhinostomy for the treatment of chronic dacryocystitis.Methods:The clinical data of 45 eyes of 40 cases of chronic dacryocystitis who received dacryocystorhinostomy under nasal endoscope from Dec. 2013 to Dec. 2018 in the 988th Hospital of PLA were collected and analyzed retrospectively. All cases were divided into two groups.The treatment group, 22 eyes of 21 cases received dacryocystorhinostomy anastomosis applied with mitomycin C cotton for 5 minutes.The control group, 23 eyes of 19 cases received dacryocystorhinostomy without mitomycin C cotton. The followed-up time was 6 months. The efficacy of the two groups were observed and compared.Results:In the treatment group, 19 eyes were cured, 2 eyes were improved, and 1 eye was ineffective (relapsed). In the control group, 11 eyes were cured, 4 eyes were improved, and 8 eyes were ineffective (relapsed). The difference in effective rate between the two groups was statistically significant (n χ2=4.670, n P=0.032). The intraoperative blood loss in the treatment group was (35±10) ml, which was less than the (40±15) ml in the control group. The difference was statistically significant between the two groups (n t=2.096, n P=0.019). There was no significant difference in time of operation between the two groups (n t=1.548, n P=0.065). The anastomotic formation time of dacryocystorhinostomy in the treatment group was shorter than that in the control group (n t=3.354, n P=0.001). The anastomotic closure was found in 1 eye (4.55%, 1/22) of the treatment group, and 8 eyes (34.78%, 8/23) in the control group.n Conclusion:Application of mitomycin C in nasal endoscopic dacryocystorhinostomy for the treatment of chronic dacryocystitis can significantly reduce the recurrence rate.
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