鼻内镜联合丝裂霉素C治疗复发性泪囊炎21例临床分析

Nasal endoscopy combined with mitomycin C in the treatment of recurrent dacryocystitis : clinical analysis of 21 cases

目的探讨复发性泪囊炎经鼻内镜下联合丝裂霉素C和泪道引流管行泪囊鼻腔造口术的疗效。方法 2007～2011年对曾行泪囊炎鼻腔吻合术术后6月～5年复发,仍存在流泪、泪道冲洗不通,有脓性分泌物的患者21例(21侧),在鼻内镜下行泪囊鼻腔造口术,同时应用丝裂霉素C棉片放置在造口处5min,再用生理盐水冲洗,并置硅胶管从下泪小管导入鼻腔固定。术后定期冲洗泪道,鼻内镜下复查,对有瘢痕增生及有肉芽组织形成倾向者局部贴附丝裂霉素C。3个月拔管。结果 21例患者术后随访6个月到一年,治愈18例(85.7%),好转3例(14.3%),总有效率100%。结论复发性泪囊炎的患者通过在鼻内镜下联合丝裂霉素C并放置引流管行泪囊鼻腔造口术仍可获得良好的疗效。

Objective To discuss the curative effect of recurrent dacryocystit in treatment with dacryocystorhinotomy under nasal endoscope. Methods The patients under dacryocystitis and nasal cav- ity anastomosis from 2007 to 2011, 21eases （ 21 eyes） of whom were still cry, lacrimal duct flush, illog- ical, purulent secretions 6 months to 5years after the surgery. The 21 patients under endoscopic dacryo- cystorhinostomy operation combined with mitomycin C cotton sheet placed over the stoma for 5min, a- gain with saline water rinse, then silicone tube was set from the lower lacrimal canaliculus into nasal cav- ity to fix. Regular flushing of the lacrimal and extubation postoperative 3 months. Results 21 cases were followed up for 6 months to 1 year, 18 （85.7%） cases were cured, 3cases（14.3%） improved, the total efficiency was 100%. Conclusions Dacryocystorhinotomy under nasal endoscope combined with mitomy- cin C for treatment of recurrent dacryocystitis can still get a good effect.