贝复舒在经鼻内镜鼻腔泪囊造孔术中的临床应用

Application of bFGF in endoscopic dacryocystorhinostomy

目的:探讨贝复舒在鼻内窥镜下鼻内泪囊鼻腔造孔术治疗慢性泪囊炎的手术效果,对预防术后造孔口远期瘢痕粘连的临床效果。方法:经鼻内窥镜下鼻内泪囊腔造孔术治疗的慢性泪囊炎37例37眼,术后创面涂贝复舒眼用凝胶,每次随访给予清除鼻腔内泪囊造孔处的分泌物、血痂及肉芽,行泪道冲洗,术腔创面涂贝复舒眼用凝胶,待鼻腔内泪囊造口处黏膜上皮化后予拔管(3mo)。结果:随访6mo～1a治愈32眼,好转4眼,无效1眼,有效率97%(36/37),无并发症发生。1例无效患者均为造孔口肉芽组织增生粘连或与鼻中隔粘连引起,给予鼻内镜下清理闭锁造孔处,重新置管,恢复好。结论:在鼻内窥镜下鼻内泪囊鼻腔造孔术应用贝复舒,术后远期效果好、复发率低,是治疗慢性化脓性泪囊炎的较佳方法。

AIM： To discuss the application of bFGF in endoscopic dacryocystorhinostomy for the treatment of chronic dacryocystitis and for the prevention of long-term cicatri-cial adhesion of pore-forming rim after operation. METHODS： Thirty-seven cases （37 eyes） with chronic dacryocy-stitis were treated by endoscopic dacryocystor-hinostomy. The wound was coated with bFGF eye gel; the secretion, blood callus and granulation around the nasal lacrimal sac stoma were cleared during each follow-up; lacrimal passage was irrigated; after the epithelization of mucous membrane of the nasal lacrimal sac stoma, the tube was pulled out. RESULTS： After 6 months to 1 year, 32 eyes were cured, 4 eyes were improved and 1 eye was invalid. The effective rate was 97.3%, and there were no compli-cations. Invalid in 1 case was caused by proliferation and adhesions of granulation tissue around the nasal lacrimal sac stoma or nasal septum adhesion. After occlusion stoma was cleared under nasal endoscope and the patient was re-catheterized and got a better recovery. CONCLUSION： Endoscopic nasal surgery dacryocystor-hinotomy with application of bFGF has a good long-term effect,low recurrence rate, and seems to be a better method for the treatment of chronic suppurative dacryocystitis.