单纯鼻内镜下泪囊鼻腔吻合术与联合泪小管置管术治疗慢性泪囊炎的临床疗效对比

Comparison of Clinical Efficacy between Endoscopic Dacryocystorhinostomy and Combined Lacrimal Tube Placement in Treating Chronic Dacryocystitis

目的比较单纯鼻内镜下泪囊鼻腔吻合术与联合泪小管置管术治疗慢性泪囊炎的临床疗效。方法纳入2020年1月—2022年6月山西省运城眼科医院诊治的慢性泪囊炎患者99例(104只眼),随机分为对照组50例(52只眼)和观察组49例(52只眼)。对照组予单纯鼻内镜下泪囊鼻腔吻合术治疗;观察组在对照组的基础上联合泪小管置管术治疗。于术后7 d对受试者进行视觉模拟量表(VAS)评估,于术后3个月统计临床疗效和手术并发症的发生率。结果(1)VAS评分:观察组VAS评分高于对照组,差异有统计学意义(t=15.755,P=0.000)。(2)临床疗效:观察组总有效率高于对照组,差异有统计学意义(χ2=7.751,P=0.023)。(3)并发症发生率:2组并发症发生率比较,差异无统计学意义(P>0.05)。结论对患者采用鼻内镜下泪囊鼻腔吻合联合泪小管置管术,虽然术后早期会引起患者轻度不适感,但有利于提高术后远期成功率。

OBJECTIVE To compare the clinical efficacy of endoscopic dacryocystorhinostomy(En-DCR)alone versus combined lacrimal tube placement in the treatment of chronic dacryocystitis.METHODS A total of 99 patients(104 eyes)treated for chronic dacryocystitis at Yuncheng Eye Hospital of Shanxi Province from January 2020 to June 2022 were included and randomly divided into a control group of 50 cases(52 eyes)and an observation group of 49 cases(52 eyes).The control group received conventional En-DCR,while the observation group received combined lacrimal tube placement in addition to the treatment in the control group.Visual analogue scale(VAS)assessment was conducted on the seventh day postoperatively,and the clinical efficacy and incidence of surgical complications were evaluated at three months postoperatively.RESULTS(1)VAS scores:The VAS scores in the observation group were higher than those in the control group,and the difference was statistically significant(t=15.755,P=0.000).(2)Clinical efficacy:The total effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(χ2=7.751,P=0.023).(3)Incidence of complications:There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).CONCLUSIONS The usage of En-DCR combined with lacrimal tube placement in patients,although causing mild discomfort in the early postoperative period,is beneficial for improving the long-term success rate postoperatively.