硅胶泪道扩张引流管与医用自交联透明质酸钠凝胶在鼻内镜泪囊鼻腔吻合术患者中应用效果比较

Comparison of effects of silicone lacrimal duct dilation and drainage tube and medical self-crosslinked sodium hyaluronate gel in patients undergoing endoscopic dacryocystorhinostomy

目的:比较硅胶泪道扩张引流管与医用自交联透明质酸钠凝胶在鼻内镜泪囊鼻腔吻合术患者中的应用效果。方法:选取2019年4月至2021年9月该院收治的133例行鼻内镜泪囊鼻腔吻合术的患者进行前瞻性研究,按照随机数字表法将其分为观察组65例(75眼)与对照组68例(83眼)。术中对照组采用医用自交联透明质酸钠凝胶处理吻合口,观察组采用硅胶泪道扩张引流管处理吻合口,比较两组临床疗效、疼痛视觉模拟评分法(VAS)评分和并发症发生率。结果:术后2、5个月,两组治疗总有效率比较,差异无统计学意义(P>0.05);术后6、12、24、48 h,观察组VAS评分低于对照组,差异均有统计学意义(P<0.05);观察组并发症发生率为16.92%,低于对照组的42.65%,差异有统计学意义(P<0.05)。结论:硅胶泪道扩张引流管应用于鼻内镜泪囊鼻腔吻合术患者可降低术后VAS评分和并发症发生率,效果优于医用自交联透明质酸钠凝胶。

Objective:To compare effects of silicone lacrimal duct dilation and drainage tube and medical self-crosslinked sodium hyaluronate gel in patients undergoing endoscopic dacryocystorhinostomy.Methods:A prospective study was conducted on 133 patients who underwent endoscopic dacryocystorhinostomy in the hospital from April 2019 to September 2021.According to the random number table method,they were divided into observation group(65 cases,75 eyes)and control group(68 cases,83 eyes).During the surgery,the control group was treated with medical self-crosslinked sodium hyaluronate gel,while the observation group was treated with silicone lacrimal duct dilation and drainage tube.The clinical efficacy,the pain visual analogue scale(VAS)score,and the incidence of complications were compared between the two groups.Results:2 months and 5 months after the surgery,there were no significant differences in the total effective rate between the two groups(P>0.05).6,12,24 and 48 h after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 16.92%,which was significantly lower than 42.65%in the control group,the difference was statistically significant(P<0.05).Conclusions:The silicone lacrimal duct dilatation and drainage tube in the patients undergoing endoscopic dacryocystorhinostomy can reduce the postoperative VAS scores and the incidence of complications.Moreover,it is superior to the medical self-crosslinked sodium hyaluronate gel.