目的:比较丝裂霉素C和曲安奈德浸渍的生物可降解鼻腔填塞(TABP)辅助应用于鼻内镜下鼻腔泪囊吻合术(DCR)的成功率和并发症。并评价术中结合丝裂霉素C和TABP用于内镜下DCR的疗效。
方法:对148例因获得性鼻泪管阻塞而接受内镜下DCR治疗的198只眼进行回顾性分析。将患者随机分为三组:A组包括术中不使用丝裂霉素C但使用TABP的患者,B组包括不使用曲安奈德但术中使用丝裂霉素C和生理盐水灌注鼻腔填塞的患者,C组包括术中接受丝裂霉素C和TABP治疗的患者。
结果:结果显示A组(86.8%)和B组(89.2%;P=0.377)之间的总体成功率没有显着差异。然而,C组(97.5%)的总体成功率明显高于A组和B组,C组(5%)的肉芽肿发生率明显低于A组(20.8%)和B组(15.2%,P=0.009)。其他并发症,比如地壳,synechiae,和翻修手术,三组间无显著差异。
结论:术中联合应用丝裂霉素C和TABP可有效预防肉芽肿,提高手术成功率。此外,单独使用丝裂霉素C或TABP之间没有统计学上的显着差异。
OBJECTIVE: To compare the success rate and complications of adjuvant use of mitomycin C and triamcinolone-impregnated biodegradable nasal packing (TABP) in endoscopic dacryocystorhinostomy (DCR). And to evaluate the efficacy of combining intraoperative mitomycin C and TABP for endoscopic DCR.
METHODS: A total of 198 eyes of 148 patients who underwent endoscopic DCR for acquired nasolacrimal duct obstruction were retrospectively analysed. The patients were randomly divided into three groups: Group A included patients treated without intraoperative mitomycin C but with TABP, Group B included patients treated without triamcinolone but with intraoperative mitomycin C and normal saline-impregnated nasal packing, and Group C included patients treated with intraoperative mitomycin C and TABP.
RESULTS: The results revealed no significant difference in the overall success rates between Groups A (86.8%) and B (89.2%; P=0.377). However, Group C (97.5%) showed a significantly higher overall success rate than Groups A and B. The incidence of granulomas was significantly lower in group C (5%) than in Groups A (20.8%) and B (15.2%; P=0.009). Other complications, such as crust, synechiae, and revision surgery, did not differ significantly among the three groups.
CONCLUSIONS: The combination of intraoperative mitomycin C and TABP effectively prevents granulomas and enhances surgical success rate. Additionally, there is no statistically significant difference observed between the use of mitomycin C or TABP alone.