鼻内镜下鼻腔泪囊吻合术两种造口处理方法的疗效比较

Comparative study on the therapeutic effects of dacryocystorhinotomy with two kinds of neostomic procedures under nasal endoscope

目的比较鼻内镜下鼻内法鼻腔泪囊吻合术两种不同造口处理方法对疗效的影响。方法2002～2004年间收治的36例(44眼)泪道阻塞患者,随机分为两组,术中分别采用两种不同的造口处理方法,比较其疗效差异。结果置管联合覆盖抑制剂法组治愈76.2%,好转14.3%,无效9.5%,总有效率90.5%;射频联合银夹法组治愈80.0%,好转13.3%,无效6.6%,总有效率93.3%。疗效的组间差异无统计学意义(P>0.05)。结论鼻内镜下行鼻腔泪囊吻合术时,两种常用的造口处理方法对疗效无明显影响。

Objective To observe the differences in therapeutic effect of dacryocystorhinotomy with two kinds of neostomic procedures under nasal endoscope based on a clinical trial in a comparative way. Methods Thirty-six patients （44 eyes） with obstruction of lacrimal passage were randomly divided into two groups to receive the operation of dacryocystorhinotomy under nasal endoscope, to be operated on all the same for them during the surgical process but treated to the newly formed aperture of lacrimal passage in nasal cavity with different operating procedures, one treated by tube insertion combined with cellular proliferation-inhibiting reagent applying （group 1, G1） and the other by radiofrequency treatment combined with silver clamp clipping （group 2, G2）. Then, a comparative study was made to analyze the differences in the therapeutic effect between them following the surgery. Results For the cases in G1, the curative rate was 76.2%, effective rate was 14.3% and ineffective rate was 9.5%, with a total effective rate of 90.5%, and for those in G2, these rates were 80.0%, 13.3%, 6.6% and 93.4% respectively, with no significant differences seen in the therapeutic effect between them （P〉0.05）. Conclusions There are no significant differences in the therapeutic effects of dacryocystorhinotomy with the newly formed aperture of lacrimal passage in nasal cavity treated by either one of these two kinds of neostomic procedures commonly used in clinical practice for such an obstructive lesion of lacrimal passage, carried out under nasal endoscope.