鼻內窥镜下泪囊鼻腔造孔联合置管与银夹法临床疗效初步观察

Initial observation of the clinical efficacy of endoscopic dacryocystorhinostomy with silicone intubation or silver clip fixation

目的观察鼻內窥镜下泪囊鼻腔造孔联合置管与银夹法的临床疗效。方法将13例患者(15只眼)随机分到A组及B组,A组患者施行经鼻內窥镜下泪囊鼻腔造孔联合置管术,B组患者施行经鼻內窥镜下银夹法泪囊鼻腔造孔术。术后观察症状改善、泪道通畅和造孔口的情况。结果术后随访4～18个月,A组7例(9只眼)治愈,治愈率100%;B组6例(6只眼),其中1只眼出现吻合口阻塞,经清理后治愈,1只眼吻合口阻塞经反复清理后溢泪症状无改善,造孔有闭锁趋向,予置管后治愈,有效率83%。结论鼻内镜下鼻腔泪囊造孔联合置管较稳妥,疗效确切,联合银夹法需定期予内窥镜检查、清理造孔口。

Objective To observe the clinical efficacy of endoscopic dacryocystorhinostomy with silicone intubation or silver clip fixation.Methods Thirteen subjects（with fifteen sick eyes） underwent chronic dacryocystitis were divided into Group A and B rando mly.Patients in Group A were performed endoscopic dacryocystorhinostomy with silicone intubation while Group B were undergone endoscopic dacryocystorhinostomy with silver clip fixation.The condition of symptom improvement,irrigation of lacrimal passages and stoma obstruction after surgery were surveyed.Results Followed up for 4~18 months,seven patients in Group A（with nine sick eyes） were healing well.The cure rate was 100%.In Group B（6 patients with 6 eyes）,one patient who appeared stoma obstruction were cured after cleaning the stoma.And another patient needed silicone intubation to be cuerd because the epiphoraing was unimproved after iterative cleaning and the stoma was tended to atresia.Group B＇s effective power was 83%.Conclusion Endoscopic dacryocystorhinostomy with silicone intubation is safe and effective.Patient have endoscopic dacryocystorhinostomy with silver clip fixation needed endoscopy examination and stoma cleaning regularly.