鼻内镜下鼻腔泪囊吻合术治疗高龄急性泪囊炎患者的临床效果

Clinical effect of nasal endoscopic dacryocystorhinostomy in the treatment of elderly patients with acute dacryocystitis

目的探讨鼻内镜下鼻腔泪囊吻合术治疗高龄急性泪囊炎患者的临床效果。方法选取2016年3月至2021年3月本院收治的100例高龄急性泪囊炎患者作为研究对象,采用抽签方式随机将其分为试验组和参照组,每组50例。试验组实施鼻内镜下鼻腔泪囊吻合术治疗,参照组实施传统吻合术(经内眦皮肤路径鼻腔泪囊吻合术)治疗。比较两组的治疗效果、手术及术后恢复情况、并发症发生情况、炎症指标及面部美观情况。结果试验组的治疗总有效率为96.00%,高于参照组的82.00%,差异具有统计学意义(P<0.05)。试验组的术前准备时长、住院时长、溢脓持续时长、溢泪持续时长、疼痛持续时长均明显短于参照组,差异具有统计学意义(P<0.05);两组的手术持续时长比较,差异无统计学意义(P>0.05)。试验组的术后并发症总发生率为4.00%,显著低于参照组的18.00%,差异具有统计学意义(P<0.05)。入院时,两组的白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平无明显差异(P>0.05);完成手术后1周,试验组的IL-6、TNF-α、CRP水平显著低于参照组,IL-10水平显著高于参照组,差异具有统计学意义(P<0.05)。试验组的整体美观率为92.00%,显著高于参照组的76.00%,差异具有统计学意义(P<0.05)。结论鼻内镜下鼻腔泪囊吻合术治疗高龄急性泪囊炎患者的整体治疗时长短、治疗效果佳、并发症少,安全性较高,且该术式还能够与抗感染治疗同时进行,继而降低疾病对患者造成的不良影响,具有重要的应用价值。

Objective To investigate the clinical effect of nasal endoscopic dacryocystorhinostomy in the treatment of elderly patients with acute dacryocystitis.Methods From March 2016 to March 2021,100 elderly patients with acute dacryocystitis admitted in our hospital were selected as the research objects,and the patients were randomly divided into experimental group and reference group by drawing lots,with 50 cases in each group.The experimental group was treated with nasal endoscopic dacryocystorhinostomy,and the reference group was treated with traditional anastomosis(nasal lacrimal sac anastomosis through inner canthus skin path).The therapeutic effect,operation and postoperative recovery,complications,inflammatory indexes and facial aesthetics of the two groups were compared.Results The total effective rate of treatment in the experimental group was 96.00%,which was higher than 82.00%in the reference group,and the difference was statistically significant(P<0.05).The preoperative preparation time,hospitalization time,pyorrhea duration,epiphora duration and pain duration in the experimental group were significantly shorter than those in the reference group,and the differences were statistically significant(P<0.05);there was no significant difference in the operation duration between the two groups(P>0.05).The total incidence of postoperative complications in the experimental group was 4.00%,which was significantly lower than 18.00%in the reference group,and the difference was statistically significant(P<0.05).At admission,there were no significant differences in the levels of interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)between the two groups(P>0.05);at 1 week after operation,the levels of IL-6,TNF-αand CRP in the experimental group were significantly lower than those in the reference group,the level of IL-10 was significantly higher than that in the reference group,and the differences were statistically significant(P<0.05).The overall aesthetic rate in the experimental group was 92.00%,which was significantly higher than 76.00%in the reference group,and the difference was statistically significant(P<0.05).Conclusion Nasal endoscopic dacryocystorhinostomy in the treatment of elderly patients with acute dacryocystitis has the advantages of short overall treatment time,good treatment effect,few complications and high safety,and it can also be carried out simultaneously with anti-infective treatment,thus reducing the adverse effects caused by the disease to patients,which has important application value.