摘要
目的探讨在经鼻内镜泪囊鼻腔吻合术中应用丝裂霉素C、5-氟尿嘧啶、透明质酸钠治疗慢性泪囊炎的临床疗效。方法将155例(166眼)慢性泪囊炎患者随机分为丝裂霉素C组(MMC组)、5-氟尿嘧啶组(5-Fu组)、透明质酸钠组(SH组)和对照组。在经鼻内镜泪囊鼻腔吻合术中局部分别应用0.4 mg/mL丝裂霉素C、50 mg/mL5-Fu、10 mg/mL透明质酸钠;对照组仅行经鼻内镜泪囊鼻腔吻合术,术中不用药物;术后随访12个月,观察患者泪道通畅情况,鼻内镜下测量造瘘口面积,检查鼻腔结构恢复情况。结果①MMC组44眼治愈43眼,治愈率97.7%;5-Fu组38眼治愈35眼,治愈率92.1%;SH组44眼治愈40眼,治愈率90.9%。对照组40眼治愈35眼,治愈率87.5%,手术治愈率明显高于对照组,其差异有统计学意义(χ2=5.62,P=0.019;χ2=7.84,P=0.029;χ2=5.78,P=0.016)。治疗组的治愈率与对照组的治愈率比较差异有统计学意义(P<0.05);②术后6个月对照组与治疗组间吻合口大小差异有统计学意义(F=6.096,P=0.006)。但治疗组间差异无统计学意义(P=0.564)。术后12个月,前3组造瘘口面积都明显大于对照组(F=6.162,P=0.002);MMC组术后造瘘口面积大于5-Fu组,差异有统计学意义(P=0.022)。MMC组术后造瘘口面积大于SH组,差异有统计学意义(P=0.034)。5-Fu、SH组两组间比较,差异无统计学意义(P=0.719)。结论在经鼻内镜泪囊鼻腔造瘘术中局部应用药物能有效提高手术治愈率,并且应用MMC效果优于5-Fu和SH。
Objective To assess the efficacy of mitomycin C （MMC）, 5-Fluorouracil and sodium hyaluronate in dacryosystorhinostomy （DCR） for chronicity dacryocystisis. Methods One hundred and fifty-five cases （one hundred and sixty-six eyes） of chronicity dacryocystisis were randomly divided into the mitomycin C group, the 5-Fluorouracil group, the sodium hyaluronate group and the control group. The surgical procedures were exactly the same except that 0.4 mg/mL mitomycin C, 50 mg/mL 5-Fluorouracil, 10 mg/m sodium hyaluronate were used in the three groups, and in the control group, the dacryosystorhinostomy procedures were employed . All the cases were followed up for 12 months. The condition of lacrimal passages was observed, area of orificium fistulae was measured by endoscopes, and the recovery of the nasal cavity was monitored. Results （ 1 ） In the four groups ： the recovery rate in test team （43/44 eyes（97.7% ） in the mitomycin C group, 35/38 eyes （ 92.1% ） in the 5-Fluorouracil group, 40/44 eyes （90.9%） in the sodium hyaluronate group） was obviously higher than that in the control group（35/40 eyes （ 87.5% ） ） with a sta- tistically significant difference between the test groups and the control group （Xa = 5.62, P = 0. 019 ; X2 = 7.84, P = 0. 029 ; X2 = 5.78, P=0. 016）. （2） The difference of area of the orificium fistulae between the test groups and the con- trol group showed statistical significance in 6 months after the operation（ F = 6.096, P = 0.006）, but showed no statisti- cal significance in the three test groups（P =0. 564）. The area of the orificium fistulae between the test groups and the control group showed statistical significance （F = 6. 162, P = 0.002）. The area of the orificium fistulae in the mitomycin
C group was bigger than that in the 5-Fluorouracil group, and the difference had statistical significance （ P = 0. 022）. The area of the orificium fistulae in the mitomycin C group was bigger than the sodium hyaluronate group, and the differ
出处
《山东大学耳鼻喉眼学报》
CAS
2011年第6期58-61,共4页
Journal of Otolaryngology and Ophthalmology of Shandong University
