改良鼻腔泪囊吻合术的临床疗效观察

Clinical observation of dacryocystorhinostomy by improving nasal lacrimal sac mucosal flap sutured

目的观察改良鼻腔泪囊吻合术的手术成功率和远期效果。方法将进行鼻腔泪囊吻合术的40例（58眼）患者随机分为2组：一组为治疗组（20例30眼）,在行鼻腔泪囊吻合手术时鼻黏膜瓣和泪囊黏膜瓣采用改良的方法缝合在对应的眼轮匝肌缘上,关闭眼轮匝肌层时两黏膜瓣缘尽量对合并在其附近再加固1-2针;另一组为对照组（20例28眼）,在行鼻腔泪囊吻合手术时鼻黏膜瓣和泪囊黏膜瓣采用传统的对合缝合方法,对2组的疗效进行分析比较。结果对2组患者术后的伤口愈合情况、有无溢泪、冲洗泪道的通畅情况进行统计比较,结果治疗组总有效率为96.7%,对照组总有效率为71.4%。结论在鼻腔泪囊吻合术中将鼻腔黏膜和泪囊黏膜采用改良的方法缝合手术成功率高,远期效果好,值得推广应用。

Objective By observating the threatment effection of the improved fit dacryocystorhinostomy surgery method and the conventional dacryocystorhinostomy surgery method. Methods The 40 patients（58 eyes） of dacryocystorhinostomy were randomly divided into two groups,A group for the treatment group（20cases,30eyes）,surgical operation of dacryocystorhinostomy were used a modified method of suture the nasal valve surgery and lacrimal sac mucosal flap to the corresponding edge of the orbicularis muscle,Close the orbicularis muscle mucosal flap edge as possible when the two merge in the vicinity of the reinforcement and then one or two needle.The other was the control group（20cases 28eyes）,Line dacryocystorhinostomy also used the traditional method of stitching surgery nasal lacrimal and sac mucosal flap valve togethe,analysed the efficacy of variance. Results statistical compared to postoperative wound healing,with or without epiphora,lacrimal patency etc.Results the treatment group,the total effective rate was96.7%;the control group,the total effective rate was 71.4%. Conclusion dacryocystorhinostomy of nasal mucosa and lacrimal sac mucosal suture using a modified method of surgical have high success rate and long-term effect,can be widely used in clinical promotion.