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[摘要]
目的:探讨鼻内镜下泪囊鼻腔吻合术联合丝裂霉素C(MMC)治疗鼻泪道阻塞的疗效和安全性。
方法:选择32例38眼鼻泪道阻塞(或伴泪囊炎、泪囊脓肿)患者,鼻内镜下鼻丘处制成骨孔,切开泪囊并充分翻转泪囊前后瓣,0.1g/L MMC棉球于泪囊吻合口保留48h后取出。
结果:术后7d; 3,6mo行鼻内镜检查并冲洗泪道。术后7d,治愈34眼,好转3眼,无效1眼,治疗好转率97.4%; 术后3mo,治愈32眼,好转4眼,无效2眼,治愈好转率94.7%; 术后6mo,治愈32眼,好转4眼,无效2眼,治疗好转率94.7%。所有病例,均未发生鼻出血和眼眶内并发症等术后并发症。
结论:鼻内镜下泪囊鼻腔吻合术联合MMC治疗鼻泪道阻塞(或伴泪囊炎、泪囊脓肿)是一种安全有效的治疗方法。
[Key word]
[Abstract]
AIM:To explore the outcome and safety of endonasal dacryocystorhinostomy(EN-DCR)with the use of adjunctive mitomycin C(MMC)in nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess.
METHODS: Select the 32 cases(38 eyes), noses and lacrimal duct obstruction(or with dacryocystitis, lacrimal sac abscess)in patients with endoscopic nasal bone hole made at the mound, removal of the nasal mucosa, lacrimal bone and a fragment of frontal process of maxilla. cut the lacrimal sac and fully flip flap, 0.1g/L MMC retained tampon in lacrimal anastomotic removed after 48 hours.
RESULTS: Postoperative 7 days, 3 and 6 months nasal endoscopy and lacrimal irrigation. Postoperative 7 days, healing 34 eyes, improved in 3 eyes, ineffective 1 eye, treatment improvement rate was 97.4%; postoperative 3 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, healing rate was 94.7%; postoperative 6 months, cured 32 eyes, improved in 4 eyes, invalid 2 eyes, treatment improvement rate was 94.7%. All cases did not occur nasal bleeding, orbital complications and postoperative complications.
CONCLUSION: Results suggest that EN-DCR with MMC is a safe and successful procedure for the treatment of nasolacrimal duct obstruction or within dacryocystitis or lacrimal sac abscess.
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