两种术式治疗慢性泪囊炎疗效和满意度对照

A controlled research on curative effect and postoperative sationfaction of two different surgical procedures in chronic dacryocystitis patient

目的观察鼻外泪囊鼻腔吻合术(external dacryocystorhinostomy,EDCR)和内镜下泪囊鼻腔造孔术(intranasal endoscopic dacryocystorhinostomy,IEDCR)治疗慢性泪囊炎的疗效,评价患者术后满意度。方法采用随机对照设计,108例慢性泪囊炎患者被分为内镜组和对照组,分别行IEDCR和EDCR,记录症状体征变化、手术时间、住院天数和医疗费用等。随访1～5年,采用术后间隔满意尺度调查患者对手术的满意程度。结果①两组症状体征积分、手术时间、住院时间无统计学差异,内镜组住院费用高于对照组;②内镜组和对照组5年复发率分别是12.82%和15.56%,LogRank检验,χ2=0.394,P=0.530;③内镜组和对照组术后满意度评分分别是(81.70±10.242)分和(75.72±10.653)分,近似正态分布,t=-2.974,P=0.004。结论两种术式治疗慢性泪囊炎疗效相似,但IEDCR因为微创,不影响美容,是更为理想的治疗方法。

OBJECTIVE To observe the curative effect of external dacryocystorhinostomy （EDCR） and intranasal endoscopic dacryocystorhinostomy （IEDCR） for chronic dacryocystitis, and to evaluate the postoperative satisfaction of the patients. METHODS According to randomized controlled design, 108 chronic dacryocystitis patients were divided into the intranasal endoscopic dacryocystorhinostomy group and control group, both groups underwent intranasal dacryocystorhinostomy and external dacryocystorhinostomy respectively. The changes of symptom and clinical sign, operation time, hospital day, cost of hospitalization were recorded. All patients were followed up for 1-5years, and the postoperalive satisfaclion of the patients were investigated by interval satisfaction scale. RESULTS ①There were no significant difference between the groups at the curative effect, operation time and hospital day, the hospitalization cost of the intranasal endoscopic dacryocystorhinostomy group was higher than that of the control group; ②The recurrence rate of the intranasal endoscopic dacryocystorhinostomy group and control group were 12.82% and 15.56% respectively after 5 years, Log Rank test χ^2=0.394, P=0.530;③ The postoperative satisfaction of the patients in both groups were （81.70±10.242） and （75.72±10.653） score respectively, which were similar to normal distribution, t=-2.974, P=0.004. CONCLUSION The effect of intranasal endoscopic dacryocystorhinostomy for chronic dacryocystitis is similar to external dacryocystorhinostomy. But intranasal endoscopic dacryocystorhinostomy is a more ideal method, because it is minimal invasive technique and doesn＇t affect the face cosmetology.