环形硅胶管联合丝裂霉素C治疗上泪道阻塞

目的:探讨泪道置环形硅胶管联合丝裂霉素C治疗上泪道阻塞的疗效。方法:选择在门诊治疗的上泪道阻塞89例116眼:泪点阻塞14眼、泪小管阻塞38眼、泪总管阻塞64眼。随机分成两组,对照组(A组)44例58眼:泪点阻塞6眼、泪小管阻塞20眼、泪总管阻塞32眼,观察组(B组)45例58眼:泪点阻塞8眼、泪小管阻塞18眼、泪总管阻塞32眼。材料选用硅胶泪小管,自编扩泪小管绳。在上下泪小管—鼻泪管置环形硅胶管,3～6mo拔管,若合并有鼻泪管阻塞,拨环形硅胶管后立即行鼻泪管逆植球头硅胶管术。B组与A组不同的是,将浸有0.25mg/mL丝裂霉素C的扩泪小管绳在上泪道留置3～5min,拨环形硅胶管后定期冲洗泪道。平均随访2a。结果:A组治愈率为72.4%,B组治愈率为93.1%,两组治愈率比较,差异有统计学意义(P<0.01)。结论:上泪道置环行硅胶管联合丝裂霉素C能提高手术的成功率,是治疗上泪道阻塞的较理想方法。

Ring silicone tube implantation combined with mitomycin C for the treatment of upper lacrimal duct obstruction

AIM:To study the effect of ring silicone tube implanta-tion combined with mitomycin C for the treatment of upper lacrimal duct obstruction.METHODS:Eighty-nine cases (116 eyes) with upper lacrimal duct obstruction underwent the procedure of intubation in outpatient clinic:tears points obstruction(14 eyes),lacrimal duct obstruction (38 eyes),tears explorer obstruction (64 eyes). The patients were randomly divided into 2 groups. Group A consisted of 44 cases(58 eyes):tears points obstruction(6 eyes),lacrimal duct obstruction(20 eyes),nasolacrimal duct obstruction(32 eyes). Group B consisted of 45 cases(58 eyes):tears points obstruction(8 eyes),lacrimal duct obstruction(18 eyes),nasolacrimal duct obstruction (32 eyes). The materials were silicone tube,duct expansion wire which was made by myself. Two-canalicular-nasolacri-mal duct were installed ring silicone tube. The time of extubation was after 3-6 months. If the patients were also with nasolacrimal duct obstruction,inverse ball silicone tube implantation in nasolacrimal canal should be performed immediately after the extubation of the ring silicone tube. What group B distinguished from group A was indwelling duct expansion wire which is immersed in 0.25mg/mL mitomycin C for 3-5 minutes; lacrimal duct was washed regularly after extubation of ring silicone tube,and the patients were followed up for 2 years.RESULTS:The cure rate of group A was 72.4%,the cure rate of group B was 93.1%. There were significant differences in recovery rate between the two groups(P<0.01).CONCLUSION:The method of installing ring silicone tube under mitomycin C can improve the success rate of surgery and can be a better way to cure upper lacrimal duct obstruction.