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网孔状硅胶引流管与丝裂霉素C在鼻内镜额窦手术中的应用

Apply mesh silica-drainage tube and mitomycin C synchronization during surgery to the effect of endoscopic frontal sinus surgery

摘要目的 观察网孔状硅胶引流管与丝裂霉素C对鼻内镜额窦手术疗效的影响.方法 对65例(116侧)慢性额窦炎、额窦囊肿、额窦骨瘤、内翻性乳头状瘤患者,35例(64侧)鼻内镜术中同期应用网状引流管与丝裂霉素C者为MMC组;另30例(52侧)为对照组.所有患者术后均随访2~3年,将两组患者术后疗效与并发症发生率进行对比.结果 MMC组患者总有效率(97.4%)高于对照组(72.9%)(P<0.01).MMC组术后并发鼻腔粘连1例,并发症发生率为1.6%;对照组并发鼻腔粘连7例,窦口闭锁1例,鼻额管狭窄2例,息肉或肿瘤复发2例,并发症发生率为23.1%.MMC组并发症的发生率明显低于对照组(P<0.01).结论 在鼻内镜下额窦手术中同期应用网孔状硅胶引流管与丝裂霉素C可提高手术疗效,明显减少术后鼻额管狭窄、闭锁的发生率,该方法方便、安全、有效.

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abstractsObjective To investigate effect about application of mesh silica-drainage tube and mitomycin C (MMC) synchronization in endoscopic sinus surgery. Methods We selected 65 patients (116 sides)who have been operated on under nasal endoscopy in this study,included chronic frontal sinusitis,frontal mucocele,osteoma and inverted papilloma. 35 patients (64 sides) of the total was performed to apply mesh silica-drainage tube and MMC synchronization in endoscopic sinus surgery, which as MMC group;the other 30 patients (52 sides) who were not apply it as a control. What's more, all patients were followed 2 ~ 3 years after operation, and the postoperative efficacy and the incidence of complication in the two groups were compared. Results The total effective rate in MMC group(97.4%) was higher.than that of the control group(72.9%) (P<0.01). In MMC group, nasal adhesion after endoscopic sinus surgery was 1 case, and the incidence of complication was 1.6% ;but in control group, nasal adhesion was 7 cases,the ostium of frontal sinus atresia 1 case, the nasofrontal duct stenosis 2 cases, recurrence of the polyps or tumors 2 cases, so the incidence of complication was 23.1% The incidence of complication rate in MMC group was lower than that of the control group (P<0.01)Conclusion To apply mesh silica-drainage tube and mitomycin C synchronization in endoscopic sinus surgery can improve clinical effects of operation method, and postoperative complications are obviously decreased. So this method is convenient, safe and effective.

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