丝裂霉素C和5-氟尿嘧啶应用于鼻内镜泪囊鼻腔造瘘术中的疗效分析

目的探讨在经鼻内窥镜泪囊鼻腔造瘘术中应用丝裂霉素C、5-氟尿嘧啶治疗慢性泪囊炎的临床疗效。方法将95例慢性泪囊炎患者分为丝裂霉素C组、5-氟尿嘧啶组和对照组。丝裂霉素C组在经鼻内窥镜泪囊鼻腔造瘘术中局部应用0．4mg／ml丝裂霉素c；5-氟尿嘧啶组在经鼻内窥镜泪囊鼻腔造瘘术中局部应用50mg／ml5-氟尿嘧啶；对照组仅行经鼻内窥镜泪囊鼻腔造瘘术，术中不用抗代谢药物；术后随访12个月，观察患者泪道通畅情况，鼻内窥镜下测量造瘘口面积，检查鼻腔结构恢复情况。结果（1）丝裂霉素c组35例39眼，治愈38眼，治愈率97％；5-氟尿嘧啶组30例33眼，治愈30眼，治愈率87％；对照组30例34眼，治愈26眼，治愈率76％，用抗代谢药物组的治愈率与对照组的治愈率比较差异有统计学意义（P〈0．05）。（2）丝裂霉素c组与5-氟尿嘧啶组在术后造瘘口面积上差异有统计学意义（P〈0．05）。结论在经鼻内窥镜泪囊鼻腔造瘘术中局部应用抗代谢药物能有效减少术后造瘘口闭锁，提高手术治愈率，可作为一种简单、安全、有效的治疗方法。并且应用丝裂霉素c效果优于5-氟尿嘧啶。

Effects of mytomycin C, 5-Fluorouracil in nasal endoscopic dacryocystorhinostomy

Objective To discuss the clinical effect of mytomycin C, 5-Fluorouracil in nasal endoscopic daeryocystorhinostomy for curing chronic dacryocystitis. Methods Ninty-five patients with chronic dacryocystitis were divided into mytomycin C group ,5-Fluorouracil group and control group. The patients in mytomycin C group received 0. 4 mg/ml of mytomyein C when undergoing nasal endoscopic dacryocystorhinostomy. The patients in 5-Fluorouracil group received 50 mg/ml of 5-Fluorouracil when undergoing nasal endoscopic dacryocystorhinostomy, while the patients in control group received no medicine when undergoing endoscopic daeryocystorhinostomy. After 12 months of follow-up, the patients were observed the patency of lacrimal passage, measured the area of ostomy with nasal endoscope and examined the recovery of nasal passage. Results （ 1 ） Of all 39 eyes ,38 eyes were cured in 35 patients in mytomyein C group, the cure rate was 97% ;of all 33 eyes,30 eyes were cured in 30 patients in 5-Fluoreuracil group, the cure rate was 87% ;of all 34 eyes,26 eyes were cured in 30 patients in control group,the cure rate was 76%. There was a significant differences in cure rate between antimetabelites groups and control group （ P 〈 0. 05 ）. （2） There was a significant differences in the area of ostomy between mytomycin C group and 5-Fluorouraeil group （ P 〈 0. 05）. Conclusion The application of antimetabolites in nasal endoscopic daeryoeystorhinostomy is a simple, safe and effective way to treating the chronic daeryoeystitis, because it possesses the advantages of small atresia of ostomy, and high successful rate. The clinical effect of mytomyein C is better than 5-Fluoreuracil＇ s.