鼻内镜下泪囊造瘘联合泪道置管术与鼻腔泪囊吻合术的临床对比研究

Dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization

目的评价鼻内镜下泪囊造瘘联合泪道置管术的疗效。方法采用回顾性对比分析方法,收集2012年6月至2016年5月在本院治疗的慢性泪囊炎患者120例,其中采用传统鼻腔泪囊吻合手术患者60例,鼻内镜下泪囊造瘘联合泪道置管手术患者60例。对两组患者术后半年泪道通畅情况进行复查,观察术后并发症,以患者没有流泪症状,且泪道冲洗通畅为标准计算手术成功率。结果术后6个月,鼻内镜下泪囊造瘘联合置管手术成功率93.3%,传统鼻腔泪囊吻合手术成功率90.0%,差异无统计学意义(P>0.05);鼻内镜下泪囊造瘘联合置管手术皮肤瘢痕率为0,鼻腔泪囊吻合手术皮肤瘢痕率100%,差异有统计学意义(P=0.00);鼻内镜下泪囊造瘘联合置管手术复发4例,二期手术成功率为100%,鼻腔泪囊吻合手术复发6例,二期手术成功率为16.7%,差异有统计学意义(P=0.048)。结论鼻内镜下泪囊造瘘联合泪道置管手术不仅疗效可靠,更有创伤轻、无瘢痕等优点。

Objective To evaluate the clinical effect of dacryocystorhinostomy under nasal endo- scope combined with lacrimal duct catheterization. Methods The retrospective comparative study was used to analyze 120 patients with chronic dacryocystitis in our hospital from June, 2012 to May, 2016, of whom 60 patients were treated with traditional dacryocystorhinostomy, and 60 patients were treated with dacryocys- torhinostomy under nasal endoscope combined with lacrimal duct catheterization. Half year after the opera- tion the patients were re-examined for the patency of their lacrimal passages and postoperative complication. The disappearance of tearing and the unobstructed patency of the lacrimal passages were set as the standard of a successful operation. The statistically analyzing was performed. Results Six months after operation, the success rate of dacryoeystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 93.3% , the success rate of traditional daeryocystorhinostomy was 90. 0% , without statistical difference between two types of operation （ P 〉 0. 05 ）. The skin scar formation rate in daeryoeystorhinostomy under na- sal endoscope combined with lacrimal duct catheterization was 0, while 100% in traditional dacryocystorhi- nostomy, with statistical significant difference （ P = 0. 00 ）. The success rate of two-stage operation was 100% after daeryoeystorhinostomy under nasal endoscope combined with lacrimal duct catheterization for re- currence, while 16. 7% after traditional dacryocystorhinostomy, the difference is of statistical significance （P = 0. 048 ）. Conclusions Dacryoeystorhinostomy under nasal endoscope combined with lacrimal duct catheterization is not only reliable, effective method for treating chronic dacryocystitis, but also with less iat- rogenic trauma, and no scar.