丝裂霉素C辅助鼻腔泪囊吻合术治疗泪道阻塞疗效分析

Efficacy of adjunctive use of mitomycin C in dacryocystorhinostomy:a meta-analysis

目的评价丝裂霉素C(mitomycin C,MMC)辅助鼻腔泪囊吻合术治疗泪道阻塞性疾病的有效性及安全性。方法计算机检索Cochrane Library、EMbase、PubMed、中国生物医学文献数据库(CBM)、中国知网(CNKI)及维普文献数据库(VIP)。全面收集MMC辅助鼻腔泪囊吻合术治疗泪道阻塞性疾病的临床随机对照试验(RCT),评价纳入研究质量,提取有效数据,采用RevMan 5.1软件进行Meta分析。结果共纳入18个RCT,共1139眼,MMC组574眼,对照组565眼。按测量指标和干预措施进行亚组分析,结果显示:在传统鼻腔泪囊吻合术中用MMC在改善症状、保持泪道畅通及维持骨窗面积方面两组比较差异均有统计学意义;在鼻内鼻腔泪囊吻合术中用MMC在改善症状及保持泪道畅通方面两组比较差异无统计学意义但在维持骨窗面积方面两组差异有统计学意义。现有资料未提示严重不良术后并发症。结论在传统或鼻内鼻腔泪囊吻合术中应用MMC对提高手术疗效有一定的帮助。

Objective To evaluate the efficacy and safety of adjunctive use of mitomycin C in dacryocystorhinostomy to treat lacrimal passage obstruction.Methods We searched the Cochrane Library,EMbase,PubMed,CBM,CNKI and VIP to collect randomized controlled trials（RCT） of use of mitomycin C in dacryocystorhinostomy.The quality of the included trials was assessed and meta-analyses were conducted by using RevMan 5.1 software.We conducted subgroup analyses based on the outcome measures and intervention.Results A total of 18 randomized controlled trials involving 1139 eyes were included.There were significant differences in symptom-freedom and patency of the lacrimal drainage system and ostium size of external dacryocystorhinostomy with and without mitomycin C.Although there was no significant difference between the two groups in symptom-freedom and patency of the lacrimal drainage system,the difference was statistically significant in the ostium size of endonasal dacryocystorhinostomy.There were no severe postoperative complications.Conclusions The adjunctive use of mitomycin C improves the efficacy of dacryocystorhinostomy.