鼻内窥镜下鼻腔泪囊造口联合引流管置入术治疗慢性泪囊炎疗效探讨

Treatment of chronic dacryocystitis by dacryocystorhinostomy combined with drainage tube implantation under nasal endoscope

目的随访观察鼻内窥镜下鼻腔泪囊造口联合引流管置入术治疗慢性泪囊炎的疗效。方法收集2015年6月至2020年6月期间,我院收治的98例单侧慢性泪囊炎患者。所有患者术前均行常规检查,包括泪道探查和冲洗、鼻内窥镜检查和鼻窦部冠状位CT检查。手术技术是基于鼻内窥镜下鼻腔泪囊造口术,然后放置一个泪道硅胶引流管,泪道硅胶引流管放置3到4个月。解剖上的成功定义为冲洗口的通畅,而功能上的成功定义为溢脓和溢泪的消除。结果在原发性慢性泪囊炎患者中,鼻内窥镜下鼻腔泪囊造口联合引流管置入术治疗的解剖成功率为91.95%,而功能成功率为90.80%;在复发性慢性泪囊炎患者中,鼻内窥镜下鼻腔泪囊造口联合引流管置入术治疗的解剖成功率为81.82%,功能成功率为72.73%。结论本研究结果证实鼻内窥镜下鼻腔泪囊造口联合引流管置入术是治疗慢性泪囊炎的有效手术方法。实现功能和解剖成功的关键是细致的外科手术和精确的随访。

Objective To observe the curative effect of dacryocystorhinostomy combined with drainage tube in the treatment of chronic dacryocystitis.Methods A total of 98 patients with unilateral chronic dacryocystitis admitted to our hospital from June 2015 to June 2020 were collected.All patients underwent routine preoperative examinations,including lacrimal duct exploration and irrigation,nasal endoscopy,and coronal CT examination of the sinus.The surgical technique was based on a nasal endoscope dacryocystostomy followed by placement of a lacrimal duct silicone drainage tube for 3 to 4 months.Anatomical success was defined as patency of the lavage,and functional success was defined as elimination of purulent and lacrimal discharge.Results In patients with primary chronic dacryocystitis,Among patients who underwent dacryocystorhinostomy combined with drainage tube implantation under nasal endoscope,the anatomic and functional success rates of primary chronic dacryocystitis were 91.95%and 90.80%,respectively,while those of recurrent chronic dacryocystitis were 81.82%and 72.73%.Conclusions The results of this study confirmed that dacryocystorhinostomy combined with drainage tube placement under nasal endoscope is an effective surgical method for chronic dacryocystitis.The key to functional and anatomical success is careful surgery and accurate follow-up.