透明质酸钠在经鼻内镜泪囊鼻腔吻合术中的应用

Application of Sodium Hyaluronate in Endoscopic Dacryocystorhinostomy

目的探讨在经鼻内镜泪囊鼻腔黏膜吻合术(endoscopic dacryocystorhinostomy,En-DCR)治疗慢性泪囊炎中应用透明质酸钠的价值。方法 2017年1~7月,应用En-DCR治疗单眼慢性泪囊炎58例,其中33例暴露泪囊后经上泪点将医用透明质酸钠凝胶1~2 ml注入泪囊支撑再继续手术(透明质酸钠组),25例采用传统方法应用泪道探针支撑泪囊(泪道探针组)。比较2组自泪囊第一次完全暴露至明胶海绵贴敷的操作时间,以及术后2个月功能学和解剖学评分、成功率。结果透明质酸钠组自泪囊第一次完全暴露至明胶海绵贴敷的操作时间比泪道探针组短[(21.3±4.5)min vs.(26.8±5.1)min,t=-4.334,P=0.000],2组术后2个月功能学和解剖学评分、成功率均无统计学差异(P>0.05)。结论在En-DCR治疗慢性泪囊炎术中,通过上泪点将医用透明质酸钠凝胶注入泪囊辅助手术,能简化手术操作,缩短手术时间,长期术后效果尚待进一步研究。

Objective To investigate the value of sodium hyaluronate in endoscopic dacryocystorhinostomy(En-DCR)in the treatment of chronic dacryocystitis. Methods A total of 58 patients with chronic dacryocystitis were treated with En-DCR in our hospital from January 2017 to July 2017.During the operation,1-2 ml sodium hyaluronate gel was injected into the lacrimal sac via upper puncta to brace the lacrimal sacs after full exposure in 33 cases(sodium hyaluronate group),while 25 cases were given traditional method of Bowman probe to support the lacrimal sac(Bowman probe group).The partial operation time(from the first exposure of lacrimal sacs to the ending of application of gelatin sponge),functional score,anatomical score and success rate after 2 months were compared. Results The partial operation time of sodium hyaluronate group were shorter than the Bowman probe group[(21.3±4.5)min vs.(26.8±5.1)min,t=-4.334,P=0.000],while the functional score,anatomical score and success rate after 2 months had no statistical differences(P>0.05)between the two groups. Conclusion The procedure of sodium hyaluronate gel injection into the lacrimal sac via upper puncta in the En-DCR in the treatment of chronic dacryocystitis can simplify the operation and shorten the operation time,while the long-term postoperative effect remains to be further researched.