从患者角度对比经鼻内镜下鼻腔泪囊吻合术与传统鼻外径路泪囊鼻腔吻合术治疗慢性泪囊炎的疗效

Efficacy of endoscopic dacryocystorhinostomy compare to external dacryocystorhinostomy in the treatment of chronic dacryocystitis from the patient's point of view

目的从患者角度就经鼻内镜内路鼻腔泪囊吻合术(END-DCR)与传统鼻外径路泪囊鼻腔吻合术(EXT-DCR)治疗慢性泪囊炎的疗效进行比较。方法对2013年~2016年的30例进行过手术治疗的慢性泪囊炎患者进行问卷调查,其中END-DCR患者15例,EXT-DCR患者15例。以术后溢泪缓解为手术成功,患者就术后疼痛、术后溢泪缓解情况,以及如果必要是否愿意再次接受同样的手术方式进行作答。结果 15例ENDDCR和15例EXT-DCR患者术后溢泪症状均消失(100%),两组间差异无统计学意义(P>0.05)。END-DCR组患者术后第1周疼痛较EXT-DCR组更轻。所有END-DCR组患者均认为如果再次选择,仍会选择END-DCR术式。而EXT-DCR组患者仅40%患者表示愿意会仍然选择EXTDCR术式。结论 END-DCR和EXT-DCR有着相似的手术效果,但笔者更推荐患者行END-DCR。因其较EXT-DCR术后早期疼痛更轻,同时大多数患者也更乐于接受没有疤痕遗留的手术方式。

Objective To compare the endoscopic dacryocystorhinostomy （END-DCR） and external dacryocystorhinostomy （EXT-DCR） from the patient＇s point of view.Methods thirty patients who underwent EXT-DCR or END-DCR between 2013-2016 were involved in the study（END-DCR 15 cases,EXT-DCR： 15 cases）. success was defined by absence of epiphora , a questionnaire was applied to patients postoperatively. Postoperative pain, absence of epiphora were interpreted by the patients, who were also asked whether they would prefer this surgery once more if necessary. Results Total EXT-DCR and END-DCR patients epiphora were cured. There was no difference between the two groups. END-DCR group reported less pain in first week and month. All patients in END-DCR group preferred this surgery once more if necessary, only 40% in EXT-DCR preferred the same method .Conclusion Although both END-DCRs and EXT-DCRs provide similar result of surgery, we recommend the END-DCR,it caused significantly less pain in early postoperative period than the external approach. in which patients mainly were pleased to encounter a scarless surgical operation.