鼻内窥镜下鼻腔泪囊造孔术联合泪道置管治疗慢性泪囊炎疗效观察

Efficacy Evaluation of Endonasal Endoscopic Dacryocystorhinostomy(EES-DCR) with Ostial Stent Intubation in Treatment of Chronic Dacryocystitis

目的观察鼻内窥镜下鼻腔泪囊造孔术联合泪道置管术治疗慢性泪囊炎的临床疗效。方法对50例（50只眼）慢性泪囊炎患者,分成两组,每组25例,造孔组通过鼻内窥镜下鼻腔泪囊单纯造孔;联合组在造孔的基础上联合泪道置管,术中通过咬骨钳凿孔,然后将泪道再通管通过骨孔植入鼻腔内的泪囊造孔处,观察术后疗效并随访2~12个月。结果造孔组11例治愈,1例好转,10例因造瘘口周围肉芽增生无效,冲洗泪道不通,3例失访,临床有效率48%（12/25）;联合组21例治愈,2例好转,2例失访,临床有效率92%（23/25）。结论鼻内窥镜下鼻腔泪囊造孔术联合泪道置管治疗慢性泪囊炎疗效优于单纯造孔术。

OBJECTIVE To evaluate the clinical efficacy of endonasal endoscopic dacryocystorhinostomy（EES-DCR） with ostial stent intubation in treatment of chronic dacryocystitis. METHODS A retrospective study was performed from January 2014 to May 2015. All 50 patients（50 eyes） who were diagnosed as chronic dacryocystitis were equally divided into two groups： EES-DCR-only group（the first group）and EES-DCR joint with stent group（the second group）. Patients in EES-DCR joint with stent group（25 eyes） underwent endonasal endoscopic dacryocystorhinostomy（EES-DCR） with ostial stent intubation while the EES-DCR-only group（25 eyes） underwent EES-DCR only. The post-operative efficacy was observed and 2-12-month follow-up was made. RESULTS In the first group, 11 patients were cured completely and 1 patient had improvement while 10 patients failed because of periostial granulomatous proliferation and the other 3 patients lost contact. The clinical success rate was 48 %（12/25）;In the second group, 21 patients were cured completely and 2 patients had improvement while the other 3 lost contact. The clinical success rate was 92 %（23/25）. CONCLUSIONS The efficacy of endonasal endoscopic dacryocystorhinostomy（EES-DCR） with ostial stent intubation in treatment of chronic dacryocystitis is significantly better than EES-DCR only.