自交联透明质酸钠凝胶在鼻内镜下泪囊鼻腔吻合术中的应用效果

Application effect of Self-crosslinked Sodium Hyaluronate Gel in endonasal endoscopic dacryocystorhinostomy

目的探讨并研究自交联透明质酸钠凝胶在鼻内镜下泪囊鼻腔吻合术中的应用效果。方法选取2020年3月至2022年5月于九江市第一人民医院眼科行鼻内镜下泪囊鼻腔吻合术治疗的60例患者作为研究对象,根据吻合口填塞覆盖材料选择差异性将患者分为观察组、对照组,每组各30例(术眼均为30只)。对照组患者在泪囊鼻腔吻合口采用明胶海绵覆盖,观察组患者术中采用自交联透明质酸钠凝胶对泪囊鼻腔吻合口黏膜创缘进行覆盖处理。比较两组患者的治疗总有效率、并发症发生率、术后渗血严重程度、疼痛程度。结果观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组患者术后的视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05);观察组患者的瘢痕增生、肉芽组织形成发生率低于对照组,但吻合口粘连发生率高于对照组,差异有统计学意义(P<0.05);观察组患者术后渗血严重程度低于对照组,差异有统计学意义(P<0.05)。结论自交联透明质酸钠凝胶应用于鼻内镜下泪囊鼻腔吻合术,不仅能有效提高患者的治疗有效率,术后还能抑制其瘢痕增生,加快黏膜上皮化速率,加上患者术后创眼具有较高舒适度,因此其作为一种可吸收吻合口填充材料用于鼻内镜手术具有较高可行性,整体应用价值显著,值得推广。

Objective To investigate and study the application effect of Self-crosslinked Sodium Hyaluronate Gel in endonasal endoscopic dacryocystorhinostomy.Methods A total of 60 patients who received endonasal endoscopic dacryocystorhinostomy in the Department of Ophthalmology of Jiujiang First People's Hospital from March 2020 to May 2022 were selected as the research objects.By using the selection difference of anastomotic filling and covering materials,they were divided into observation group and control group,with 30 cases in each group(all patients had 30 operative eyes).In the control group,the dacryocystorhinostomy was covered by gelatin sponge.In the observation group,Self-crosslinked Sodium Hyaluronate Gel was used to cover the wound edge of the dacryocystorhinostomy mucosa.The total effective rate,complication rate,postoperative bleeding severity and pain were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Postoperative visual analogue scale(VAS)score of observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence rates of scar hyperplasia and granulation tissue formation in the observation group were lower than those in the control group,but the incidence of anastomotic adhesion was higher than that in the control group,with statistically significant differences(P<0.05).The severity of postoperative bleeding in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of Self-crosslinked Sodium Hyaluronate Gel in endonasal endoscopic dacryocystorhinostomy can not only effectively improve the treatment efficiency of patients,but also inhibit the postoperative scar hyperplasia and accelerate the rate of mucosal epithelization.In addition,the patients have a high comfort level after the surgery.Therefore,as an absorbable anastomotic filling material,it has a high feasibility for nasal endoscopic surgery.The overall application value is significant,worthy of promotion.