鼻内镜下泪囊鼻腔吻合术中常见问题及处理对策

Treatment countermeasures for common problems in dacryocystorhinostomy under nasal endoscope

目的:探讨鼻内镜下泪囊鼻腔吻合术中常见的问题及处理对策。方法:回顾我院2011-03/2013-06采用高频电刀切开鼻腔黏膜、术中止血、烧灼固定泪囊黏膜瓣与鼻黏膜瓣,亚甲蓝泪囊染色,以及泪道引流管植入和膨胀海棉支撑固定吻合口等方法,行鼻内镜下泪囊鼻腔吻合术37例43眼,观察手术效果,探讨术中常见的问题及处理方法。结果:本组37例43眼,治愈42眼(97.7%),好转1眼(2.3%),总有效率100%;所有手术均顺利完成,术中未出现严重并发症。结论:采用高频电刀切开鼻腔黏膜、术中止血、烧灼固定黏膜瓣,亚甲蓝泪囊染色,以及泪道引流管植入和膨胀海棉支撑固定吻合口等方法,能够有效地处理这些术中常见的问题,提高手术的成功率,值得应用和推广。

AIM： To discuss the common problems and treatment countermeasures in dacryocystorhinostomy under nasal endoscope. METHODS： The clinical data of 37 cases （ 43 eyes ） of postoperative dacryocystorhinostomy under nasal endoscope, by using high-frequency electric knife to open the nasal mucosa, hemostasis in surgery, burning fixed lacrimal sac mucosal flap and nasal mucosal flap, methylene blue staining of the lacrimal sac, lacrimal drainage tube implanted and expansion foam support fixed anastomotic methods were reviewed in our hospital from Mar.2011 to June.2013.The effects of surgery were observed, and the intraoperative common questions and the treatments were discussed. RESULTS：In the 37 cases （43 eyes）, 42 eyes （97.7%） were cured, and 1 eye was improved, and the total efficiency was 100%. All operations were successfully completed without any serious complications during surgery. CONCLUSION： The common complication in dacryocystorhinostomy under nasal endoscope are effectively treated and the success rates of surgery are improved, by using high-frequency electric knife to open the nasal mucosa, hemostasis in surgery, burning fixed lacrimal sac mucosal flap and nasal mucosal flap, methylene blue staining of the lacrimal sac, lacrimal drainage tube implanted and expansion foam support fixed anastomotic methods.These methods are worthy of application and promotion.