5-Fu对鼻泪道阻塞人工鼻泪管支架逆行置入术疗效的影响

Impacts of 5-Fu on effects of retrograde implantation of artificial nasolacrimal duct stent for obstruction of nasolacrimal duct

目的探讨5-氟尿嘧啶(5-Fu)对鼻泪道阻塞患者人工鼻泪管支架逆行植入手术疗效的改善作用。方法将200例鼻泪道阻塞患者随机分为对照组与观察组,各100例。对照组采用人工鼻泪管支架逆行植入术治疗,观察组术中应用5-Fu,比较两组术后3和6个月的治疗效果和手术并发症发生率,测定两组术后1 w及术后3和6个月造口大小,统计两组术后6个月复发率。结果 (1)术后3个月两组总有效率比较无统计学差异(P>0.05),术后6个月观察组总有效率高于对照组(P<0.05);(2)观察组术后泪道阻塞发生率为1.00%,低于对照组的7.00%(P<0.05);(3)两组术后1 w造口大小无统计学差异(P>0.05),术后3和6个月两组造口均缩小,且观察组缩小幅度低于对照组(P<0.05);(4)观察组术后6个月复发率低于对照组(P<0.05)。结论鼻泪道阻塞患者行人工鼻泪管支架逆行置入术中,应用5-Fu可优化手术疗效,减少术后泪道阻塞发生率,减少造口闭合,降低术后复发风险。

Objective To explore the improving effects of 5-fluorouracil （5-Fu） on the effects of retrograde implantation of artificial nasolacrimal duct stent tor obstruction of nasolacrimal duct. Methods A total of 200 patients with nasolacrimal duct obstruction were randomly divided into a control group and an observation group （n=100, respectively）. The control group received retrograde implantation of artificial nasolacrimal duct stent. 5-Fu was applied in the observation group. The effects and incidence of surgical complications three and six months after the operation between the two groups were compared. The stoma size one week and three and six months after the operation in the two groups was detected. The recurrence rate six months after the operation was calculated. Results （1）The overall response rate （ORR） three months after the operation between the two groups showed no statistic difference （P 〉 0.05）. The ORR six months after the operation in the observation group was higher than that in the control group （P 〈 0.05）; （2）the postoperative incidence of obstruction of lacrimal passage in the observation group was 1.00%, which was lower than the 7.00% in the control group （P 〈 0.05）; （3）the stoma size one week after the operation showed no statistic difference （P 〉 0.05）; the stoma three and six months after the operation in the two groups nan＇owed, and the reduction in the observation group was lower than that in the control group （P 〈 0.05）; （4）the recurrence rate six months after the operation in the observation group was lower than that in the control group （P 〈 0.05）. Conclusion The application of 5-Fu in the retrograde implantation of artificial nasolacrimal duct stent tor the obstruction of nasolacrimal duct can improve the effects, reduce the incidence of postoperative lacrimal duct obstruction, reduce stoma occlusion and lower the risk of postoperative recurrence.