丝裂霉素治疗泪囊鼻腔吻合术后重度反应的效果  

Efficacy of Mitomycin C for the treatment of serious reactions after dacryocystorhinostomy

作　　者：曾健[1] 乔岗[1] 李建全[1] 陈向晖[1] 张然[1] 赵媛[1] 

机构地区：[1]绵阳市中心医院眼科,四川621000

出　　处：《中华眼外伤职业眼病杂志》2017年第1期61-63,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 评价局部使用丝裂霉素治疗泪囊鼻腔吻合术后重度反应的效果.方法 泪囊鼻腔吻合术后反应较重者120例（120眼）,于术后在鼻内镜门诊随访复查.患者随机分为两组各60例.对照组以生理盐水冲洗,试验组清创后以0.2 g/L浓度的丝裂霉素棉片敷贴吻合口黏膜5min后再以生理盐水冲洗.之后平均随访（14.0±2.6）个月,观察泪道通畅程度及其他并发症.结果 随访期末对照组严重阻塞21例,轻、中度阻塞26例,炎症消退时间（3.5±0.6）个月;试验组严重阻塞3例,轻、中度阻塞22例,炎症消退时间（2.8±0.5）个月.据统计学处理,两组阻塞程度改善、炎症消退时间方面的差异均有统计学意义.结论 在泪囊鼻腔吻合术后重度反应者局部使用丝裂霉素是安全的,可以明显抑制增生粘连的发生,并减轻炎症反应程度,对促进泪道功能重建有帮助.Objective To evaluate the efficacy of Mitomycin C for the treatment of serious reactions after dacryocystorhinostomy.Methods The data of 120 eyes of 120 patients with serious reactions after dacryocystorhinostomy were reviewed by endoscopy.They were randomly divided into two groups.In the control group,60 paitent＇ s lacrimal duct were flushed with normal saline.In the test group,60 paitent were appressed in anastomotic stoma with 0.2g/L Mitomycin C and last for 5 minutes before lacrimal ducts were flushed.Average follow-up time was （14.0 ± 2.6） months.The degree of lacrimal duct patency and the complications were observed.Results There were 21 cases with serious obstruction and 26 cases with mild or moderate obstructive.And inflammation subsided for （3.5 ± 0.6） months in control group.Serious obstruction occurred in 3 cases and mild or moderate obstructive in 22 cases.And inflammation subsided for （2.8 ± 0.5） months in test group.The difference in the time of inflammation subsided was significant.Conclusion It is safe and effective for paitents with serious reactions using Mitomycin C after dacryocystorhinostomy.It can significantly inhibite the proliferation of adhesions occurrence,reduce inflammatory reactions,and rebuild a significant effect on the promotion of the lacrimal function.

关 键 词：泪囊鼻腔吻合术 术后反应 丝裂霉素C 疗效 

分 类 号：R779.6[医药卫生—眼科]