丝裂霉素C联合顺行泪道引流管植入治疗上泪道阻塞临床研究

Clinical Study of Mytomycin C Combined with Anterograde Lacrimal Duct Drainage Tube Implant in Treating Upper Lacrimal Duct Obstruction

目的研究丝裂霉素C(MMC)在顺行泪道引流管植入治疗上泪道阻塞中的疗效。方法选择上泪道阻塞患者166例(188眼),按治疗方法的不同分为对照组与治疗组。对照组患者40例(44眼),采用常规的泪道引流管植入术;治疗组患者126例(144眼),在对照组基础上联合MMC,按MMC质量浓度及保留时间的不同分为6组。术后平均随访(16.25±3.24)个月(6~20个月),对比对照组及治疗各组间的疗效。结果治疗组与对照组整体有效率比较,差异有统计学意义(χ~2=15.29,P<0.05);各小组有效率比较,C1组与对照组有显著统计学差异(χ~2=9.170,P<0.01);各组患者均无不良反应及手术并发症。结论顺行泪道引流管植入术中联合应用MMC可提高泪道阻塞的治愈率,0.3 g/L的MMC 0.1 m L注入泪道狭窄处并保留3 min疗效较好。

Objective To investigate the clinical efficacy of mitomycin C（MMC） in lacrimal duct drainage tube implant treatment of upper lacrimal duct obstruction. Methods Totally 166 patients（188 eyes） with upper lacrimal duct obstruction were selected and randomly divided into the control group and the treatment group according to different therapy methods. The control group（40 cases,44 eyes） was only implanted anterograde lacrimal duct drainage tube;on this basis,the treatment group（126 cases,144 eyes） were added MMC. The treatment group was divided into 6 groups according to the mass concentration and retention time of MMC. The mean follow- up was （16.25 ＋3.24） months（6-20 months）,the clinical efficacy between the two groups and among the 6 groups in the treatment were compared. Results The difference of the total effective rate in the two groups had statistical significance（X^2 = 15.29, P 〈 0.05）;in the 6 groups,the effective rate of each group was compared,there was significant difference between the C1 group and the control group （X^2=9. 170, P 〈 0.01）. There was no adverse reaction and complication in each group. Conclusion Mytomycin C combined with anterograde lacrimal duct drainage tube implant in treating upper lacrimal duct obstruction can improve the cure rate, and anterograde lacrimal duct drainage tube injected with 0. 1 mL MMC（0.3 g/L） for 3 minutes has better effect.