替吉奥胶囊致双眼泪道严重阻塞

Severe lacrimal duct obstruction in both eyes induced by tegafur,gimeracil and oteracil potassium capsules

1例49岁男性患者因患结肠癌口服替吉奥胶囊2粒(每粒含替加氟25 mg,吉美嘧啶7.25 mg,奥替拉西钾24.5 mg)、2次/d,连续用药2周,停用1周,3周为1个疗程。第2个疗程结束后,患者出现双眼流泪症状。继续服用替吉奥胶囊治疗,流泪症状加重。第3个疗程后停药,但流泪症状无改善。诊断为双眼泪道阻塞,经泪道冲洗治疗22个月后无效,患者接受双眼微小切口泪囊切开探查+逆行泪小管疏通+泪点成形+改良泪囊鼻腔吻合+双泪小管置入式人工泪管置入术。上述治疗后流泪症状消失。结合以往文献报道,考虑本例患者的双眼泪道阻塞与替吉奥有关。

A 49-year-old male patient received 2 tegafur,gimeracil and oteracil potassium capsules(each capsule containing tegafur 25 mg,gimeracil 7.25 mg,and oteracil potassium 24.5 mg)orally twice daily for 2 weeks continuously following 1 week of withdrawal(every 3 weeks was a cycle)for colon cancer.After 2 cycles of treatment,the patient developed epiphora in both eyes.He continued to take the medicine and his epiphora aggravated.After 3 cycles of treatment,the drug was discontinued but his epiphora did not improve.Lacrimal duct obstruction in both eyes was diagnosed,which did not improve after the lacrimal passage irrigation treatment for 22 months.Then the patient underwent consecutive surgical treatments on his left and right eyes,including dacryocystectomy(with tiny incision for exploration),retrograde drainage of lacrimal canaliculi,punctoplasty,modified dacryocystorhinostomy,and artificial lacrimal canaliculus implantation.After the above operations,his epiphora disappeared.Based on the previous literature,the lacrimal duct obstruction in both eyes induced by tegafur,gimeracil and oteracil potassium capsules was considered.