鼻内镜下手术治疗先天性泪囊囊肿的1年疗效观察

One year efficacy of nasal endoscopic surgery on congenital dacryocystocele

目的观察鼻内镜下手术治疗先天性泪囊囊肿的效果。设计回顾性病例系列。研究对象2018年1月至2021年1月就诊于安徽省马鞍山市砂迎医院、南京爱尔眼科医院及锦州爱尔眼科医院的先天性泪囊囊肿患者131例。方法回顾患者的病历资料,患者均行鼻内窥镜下手术(鼻囊肿造袋术或泪囊造孔术),术后随访时间3~24个月,平均(14.3±2.1)个月。通过体征(溢泪和溢脓)缓解情况及常规鼻内窥镜随访评估情况将手术效果分为三个等级:治愈:包块、溢泪、呼吸困难消失者;好转:包块消失溢脓消失,溢泪存在者(由于倒睫和泪点撕裂所致);未愈:溢脓、溢泪存在者。观察手术的治愈率、好转率及并发症情况。主要指标治愈率、好转率及并发症情况。结果所有患者末次随访时均未发现严重的术中(出血、组织损伤)、术后(出血、感染、孔闭锁)并发症。术后85.5%(112/131例)治愈;14.5%(19/131例)好转。结论鼻内窥镜手术治疗先天性泪囊囊肿安全、有效。

Objective To observe the efficacy of nasal endoscopic surgery on congenital dacryocystocele.Design Retrospective case series.Participants A total of 131 children with congenital dacryocystocele admitted to Shaying Hospital,Ma'anshan,Anhui Province,Nanjing Aier Eye Hospital,and Jinzhou Aier Eye Hospital from January 2018 to January 2021 were included.Methods The patients'data were reviewed,and all patients underwent nasal endoscopic surgery(nasal cyst endoscopic marsupialization or endoscopic intranasal dacryocystorhinostomy).The follow-up time was 3 to 24 months,with an average of(14.3±2.1)months.Cure was defined as the disappearing of the mass,overflow of tears,and breathing difficulties;improvement was defined as the disappearance of mass,overflow empyema,and the presence of residual tears(due to trocar andtears puncture);unhealed was defined as the presence of overflowing pus and tears.Main Outcomes Measures Cure rate,improvement rate and complications.Results No serious intraoperative complications(such as bleeding and tissue damage)and postoperative complications(bleeding,infection,and hole atresia)were found.85.5%cases(112/131 cases)were postoperatively cured;14.5%cases(19/131 cases)were improved after surgery.Conclusion Nasal endoscopic surgery is relatively safe,with high success rate for treatment of congenital dacryocystocele.