摘要
目的在创伤性泪道阻塞再造术中应用丝裂霉素C,观察其治疗效果。方法将41例创伤性泪道阻塞患者分为治疗组和对照组。治疗组21例,男14例,女7例,平均年龄32岁,在泪囊鼻腔吻合术中局部应用0.4mg/ml丝裂霉素C。对照组20例,男12例,女8例,平均年龄35岁,常规行泪囊鼻腔吻合术。术后行泪道冲洗,观察两组患者术后泪道通畅程度,并进行比较。结果41例创伤性泪道阻塞患者均行泪囊鼻腔吻合术,治疗组21眼,治愈眼数21眼,治愈率100%,对照组20眼,治愈眼数17眼,治愈率85%,组间比较有显著性差异(P<0.05)。治疗组远期(24个月)治愈率明显高于对照组。治疗组远期骨孔面积缩小程度较对照组小。对照组无效3例,局部可见吻合口瘢痕闭塞2例,肉芽组织阻塞1例。结论在创伤性泪道阻塞泪囊鼻腔吻合术中局部应用丝裂霉素C,能明显抑制纤维组织增生,瘢痕和肉芽组织形成,可有效提高手术成功率,且无鼻黏膜坏死、萎缩、感染及皮肤愈合不良等并发症发生,可作为一种简便、安全有效的辅助治疗手段。
Objective To investigate the effect of mytomycin C in the operation of dacryocystorhinostomy for curing lacrimal passage obstruction. Method Forty-one patients with traumatic lacrimal passage obstruction were divided into treatment group （n=21, 14 males and 7 females with an average age of 32） and control group.（n=20, 12 males and 8 females with an average age of 35）. The patients in treatment group received 0.4mg/ml of mytomycin C when undergoing dacryocystorhinostomy, while the patients in control group received no medicine when undergoing the same operation. Lacrimal passage was cleaned with water after operation, and the operational effectiveness of dacryocystorhinostomy were compared between the treatment group and control group. Results Twenty-one eyes were cured in treatment group, and the cure rate reached 100%. While for the 20 eyes in control group, 17 eyes were cured, and the cure rate was 85%. There existed statistical significance between the two groups （P〈0.05）. The cure rate in treatment group was higher than that in control group. The area of bone hole in the treatment group was larger than that in the control group. There were 3 invalid cases including 2 cases of occluded scar and 1 case of occluded granulation tissu. Conclusion The application of mytomycin C in the operation of dacryocystorhi-nostomy for curing lacrimal passage obstruction can inhibit the hyperplasia of fibrous tissue and the formation of scar or granulation tissue with no complications, such as nasal mucosa necrosis, analosis and infection, so as to elevate the achievement ratio.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2008年第11期1377-1378,共2页
Medical Journal of Chinese People's Liberation Army
关键词
创伤性泪道阻塞
泪囊鼻腔吻合术
丝裂霉素C
obstruction of the damaged lacrimal passage
dacryocystorhinostomy
mytomycin C
