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辅助丝裂霉素 C 在鼻内窥镜下泪囊鼻腔吻合术中的意义。

Significance of adjunctive mitomycin C in endoscopic dacryocystorhinostomy.

机构信息

Department of Otorhinolaryngology, R.L. Jalappa Hospital and Research Centre, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education, Tamaka, Kolar, India.

出版信息

Am J Otolaryngol. 2012 Jan-Feb;33(1):47-50. doi: 10.1016/j.amjoto.2011.01.001. Epub 2011 Mar 9.

Abstract

PURPOSE

The purpose of this study is to observe the effect of intraoperative topical application of mitomycin C (MMC) on the results of endoscopic dacryocystorhinostomy.

DESIGN

This is a prospective, randomized, controlled, single-blind study.

SETTINGS

Hospitalized treatment was done in a tertiary medical college hospital and research center that deals with a predominantly rural population.

PATIENTS

Patients with primary acquired postsaccal obstruction causing chronic dacryocystitis were considered.

METHODS

A total of 38 patients were randomized into either a mitomycin group or a control group. Both of these groups were subjected to an identical surgical procedure, except that 0.2 mg/dL of MMC was used in the mitomycin group, whereas normal saline was used in the control group. The follow-up period was at least 6 months. An asymptomatic patient with a visible stoma at nasendoscopy and free flow of saline into the nose with lacrimal syringing after 6 months after surgery was used as criteria for defining a successful result.

RESULTS

The success rate was 82.3% when MMC was used and 85.7% among the controls (P > .05). Granulations, adhesions, and obliterative sclerosis occurred in a similar number of patients of both groups. However, granulations and adhesions did not have a bearing on the success rate in either group.

CONCLUSION

Mitomycin C did not appear to influence the occurrence of granulations, synechiae, or obliterative sclerosis, nor did it alter the success rate significantly.

摘要

目的

本研究旨在观察术中局部应用丝裂霉素 C(MMC)对内镜下鼻腔泪囊吻合术结果的影响。

设计

这是一项前瞻性、随机、对照、单盲研究。

地点

在一所三级医学院附属医院和研究中心进行住院治疗,该中心主要服务于农村人群。

患者

考虑患有原发性获得性囊后阻塞导致慢性泪囊炎的患者。

方法

共 38 例患者随机分为丝裂霉素组或对照组。两组均接受相同的手术程序,但丝裂霉素组使用 0.2mg/dL 的丝裂霉素,对照组使用生理盐水。随访期至少为 6 个月。术后 6 个月,鼻内镜下可见造口、生理盐水自由流入鼻腔且泪道冲洗通畅的无症状患者被用作定义成功结果的标准。

结果

使用丝裂霉素时成功率为 82.3%,对照组为 85.7%(P>.05)。两组患者的肉芽组织、粘连和闭塞性硬化发生数量相似。然而,肉芽组织和粘连对两组的成功率均无影响。

结论

丝裂霉素 C 似乎不会影响肉芽组织、粘连或闭塞性硬化的发生,也不会显著改变成功率。

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