37例鼻内镜下改良鼻泪管逆行插管与鼻腔泪囊造孔术临床应用效果比较分析  

37 cases of analysis of modified retrograde intubation into nasolacrimal duct and dacryocystorhinostomy with nasal endoscopy

作　　者：周玲芬[1] 程凯尧[1] 

机构地区：[1]浙江省绍兴第二医院眼科,浙江绍兴312000

出　　处：《中国内镜杂志》2014年第6期616-619,共4页China Journal of Endoscopy

摘　　要：目的比较分别在鼻内镜下采用改良鼻泪管逆行插管术与鼻腔泪囊造孔术治疗慢性泪囊炎的治疗效果。方法选择2009年8月-2013年8月于该科治疗的慢性泪囊炎患者,其中采用鼻内镜下改良鼻泪管逆行插管术的患者共37例（A组）,采用鼻腔泪囊造孔术的患者共37例（B组）。A组在门诊完成治疗,B组患者收住院完成治疗。随访3个月后比较两组患者经治疗后临床症状的缓解情况。结果两组患者的治疗效果无明显差异,采用改良鼻泪管逆行插管的治疗痊愈率为53.66%,治疗有效率为90.24%,而采用鼻腔泪囊造孔术的治疗痊愈率为62.50%,治疗有效率为95.00%,经统计检验,两组间的痊愈率和有效率差异均无显著性（χ2=1.097,0.0735,均P＞0.05）。术后半年,A组复发3例,复发率7.32%,B组复发2例,复发率5.00%,χ2=0.618,P＞0.05,组间比较差异无显著性;术后1年,A组复发7例,复发率17.07%,B组复发4例,复发率10.00%,χ2=5.718,P〈0.05,A组复发率高于B组。结论在鼻内镜下无论采用改良鼻泪管逆行插管抑或是鼻腔泪囊造孔术,两者的治疗效果差异无显著性。对基层医院而言,鼻内镜下改良鼻泪管逆行插管术对术者的操作技术以及解剖知识要求相对较低,且该术式对患者造成的损伤相对较小,所需费用较低,更易于临床推广。[Objective] To compare the effect of modified retrograde intubation into nasolacrimal duct and dacryocystorhinostomy with nasal endoscopy applied in chronic dacryocystitis treatment. [ Methods ]The patients with chronic dacryoeystitis treated in our department from august 2009 to 2013 were selected. 37 cases in group A were treated by modified retrograde intubation in outpatient, while 37 cases in group B was treated by dacryoeystorhinos- tomy income homes. The remission of symptoms after treatment between the two groups were compared in 3 months follow-up. [ Results] There was no significant difference between the two groups. The cure rate in group A was 53.66%, efficiency 90.24%, while cure rate in group B was 62.50%, efficiency 95.00% （X2=1.097, 0.0735, both P〉 0.05）. Half year after operation, 3 cases in group A was recurrence （7.32%）, while 2 cases in group B recurrence （5.00%）, X2=0.618,P〉0.05, and there was no statistical difference between the 2 groups. One year after operation, 7 cases in group A was recurrence （17.07%）, while 4 cases in group B recurrence（10.00%）, X2=5.718, P〈0.05, the re- currence rate in A group was higher than that in group B. [Conclusion] Purpose of minimally invasive could be achieved by both modified retrograde intubation into nasolacrimal duet and dacryoeystorhinostomy with nasal en- doscopy, the impact on appearance could be reduced and there were no significant differences between the two kinds of methods. In primary hospital, the operation technology and anatomical knowledge required less by modified retro-grade intubation into nasolacrimal duct with nasal endoscopy, damage is minor, and costs is lower. It is easy for clinical practice.

关 键 词：鼻内镜 鼻泪管逆行插管 鼻腔泪囊造孔术 慢性泪囊炎 鼻泪管堵塞 

分 类 号：R777.2[医药卫生—眼科]