摘要
目的 探讨平阳霉素在预防慢性泪囊炎行鼻内微小切口开窗术后复发的临床价值.方法 收集近五年慢性泪囊炎患者80例(90只眼),按随机原则分为治疗组和对照组,治疗组泪囊鼻腔高位吻合口处贴敷平阳霉素棉片5 min,再用生理盐水冲洗吻合口,后植入耳科鼓膜通风管(一端在泪囊里,一端在鼻腔内),形成泪囊鼻腔引流孔,生理盐水冲洗泪道无阻力后手术结束;对照组植入耳科鼓膜通风管,形成泪囊鼻腔引流孔,不放置平阳霉素棉片.两组生理盐水冲洗泪道无阻力后结束手术,若不出血则不行鼻腔填塞.植入耳科鼓膜通风管3个月.观察术中出血、术后出血情况、手术时间等情况.结果 治疗组治愈40眼,好转4眼,无效(复发)0眼;对照组治愈38眼,好转4眼,无效(复发)4眼,两组有统计学意义(P<0.05).治疗组术中出血少(35±10)ml、术后未见出血(0±5)ml;手术时间(45±12)min,术中术后均未见明显并发症发生.对照组术中出血较多(40±15)ml、术后4眼有不同程度渗血(5±10)ml,经重新填塞凡士林纱条后止血;手术时间(42±11)min.治疗组所有病例均经半年以上随访,效果满意.结论 平阳霉素在慢性泪囊炎行鼻内微小切口鼻腔泪囊高位开窗术后预防术后复发有积极作用,可明显减少复发率,值得临床推广应用.
Objective To explore the clinical value of Pingyangmycin in preventing recurrence of chronic dacryocystitis after fenestration with intranasal mini-incision.Methods 80 cases(90 eyes)of chronic dacryocystitis patients in the past five years were collected and randomly divided into treatment group and control group.In treatment group,Pingyangmycin cotton sheet was applied at the high anastomotic site of dacryocystorhinostomy for 5 minutes,then the anastomotic site was washed with normal saline,and the tympanic membrane ventilation tube(one end in the dacryocyst and one end in the nasal cavity)was implanted to form the dacryocyst.The operation was completed after nasal drainage orifice was washed with normal saline and lacrimal duct without resistance.The control group was implanted with ear tympanic membrane ventilation tube to form lacrimal sac nasal drainage orifice without Pingyangmycin cotton sheet.Two groups of normal saline irrigation lacrimal duct no resistance after the end of the operation,if no bleeding,no nasal packing.The eardrum ventilation tube was implanted for 3 months.The intraoperative hemorrhage,postoperative hemorrhage and operation time were observed.Results In the treatment group,40 eyes were cured,4 eyes were improved,0 eyes was ineffective(recurrence);in the control group,38 eyes were cured,4 eyes were improved,4 eyes were ineffective(recurrence),two groups were statistically significant(P<0.05).In the treatment group,intraoperative bleeding was less(35±10)ml,no bleeding was observed(0±5)ml,and the operation time was(45±12)min,and no obvious complications occurred during and after the operation.The control group had more bleeding during operation(40±15)ml and bleeding in 4 eyes(5±10)ml after operation.The bleeding was stopped by refilling Vaseline gauze.The operation time was(42±11)min.All cases of the treatment group were followed up for more than half a year with satisfactory results.Conclusions Pingyangmycin plays an active role in preventing recurrence of chronic dacryocystitis after high fenestration of nasal cavity and lacrimal sac through intranasal mini-incision.It can significantly reduce the recurrence rate and is worthy of clinical application.
作者
李谊
柳韶真
LI Yi;LIU Shao-zhen(Department of Otolaryngology,No.988 Hospital of PLA,Zhengzhou,Henan 450042,China)
出处
《实用医药杂志》
2020年第7期591-593,598,共4页
Practical Journal of Medicine & Pharmacy
关键词
平阳霉素
慢性泪囊炎
鼻内窥镜
鼻腔泪囊高位微小切口开窗术
Pingyangmycin
Chronic dacryocystitis
Nasal endoscopy
Fenestration through high micro-incision of nasal lacrimal sac
