Merogel在鼻内窥镜下泪囊鼻腔吻合术中的临床应用  

Clinical application of Merogel during entranasal endoscopic dacryocystorhinostomy

作　　者：拱伟[1] 董雅儒[1] 崔极哲[1] 

机构地区：[1]吉林大学第二医院眼科,长春130041

出　　处：《临床眼科杂志》2015年第2期177-179,共3页Journal of Clinical Ophthalmology

摘　　要：目的：探讨Merogel在鼻内窥镜泪囊鼻腔吻合术中的临床应用效果。方法2014年3月至2014年10月我院收治90例（107只眼）慢性泪囊炎患者。对其施行鼻内窥镜下泪囊鼻腔吻合术，术中泪囊黏膜与鼻腔黏膜吻合口处贴敷由美国Xomed公司生产的Merogel（主要成分为透明质酸）。其中12例（12只眼）因合并泪小管、泪总管阻塞或狭窄，于术中同时置入泪道引流管（山东博士伦福瑞达公司生产制造）。其中1例术中探查见术眼上泪小管阻塞，无法探通，故未置管。所有患者的泪道引流管均于3个月后拔出。结果术后随访3个月以上，泪囊黏膜与鼻腔黏膜吻合口外形均良好，3～4周完全上皮化，无息肉生长，患者主诉无明显溢泪等不适症状，全部治愈。结论在鼻内窥镜下泪囊鼻腔吻合术中，泪囊黏膜与鼻腔黏膜吻合口处贴敷Merogel，可减少吻合口处息肉再生、肉芽组织增生，促进吻合口黏膜上皮化，降低吻合口再次闭塞的发生率，可以显著提高手术成功率。Objective To explore the clinical application effect of Merogel during entranasal endoscopic dacryo-cystorhinostomy.Methods From March 2014 to October 2014 during the hospital treated 90 cases of patients （107 eyes） with chronic dacryocystitis as the object of study.All patients received entranasal endoscopic dacryocystorhinostomy（ EES-DCR） ,during which the lacrimal sac and nasal mugosa anastomosis Was sticked and adhered by the US Xomed company＇s Merogel（the main ingredients for hyaluronic acid）.12 patients （12 eyes） due to combining with lacrimal duct, lacrimal duct obstruction or stenosis, in surgery at the same time were placed lacrimal drainage tube （ Shandong Boshilun Furuida manufacturing of the company）.one patient,s eye surgery was seen the lacrimal duct obstruction in surgery,and can not be probing, so the lacrimal drainage tube was not be placed.All the artificial lacrimal silicone tubes are pulled after three months.Results All patients were followed up more than 3 months , the shape of the lacrimal sac mucosa and nasal muco-sa anastomosis were good.After surgery 3~4 weeks ,the mucosa were complete epithelialization , no polyps.the patient complained of epiphora no other symptoms, all cured.Conclusions Endoscopic dacryocystorhinostomy, the lacrimal sac mucosa and nasal mucosa anastomosis were sticking Merogel,can reduce the anastomosis regeneration of polyps, granulation tissue, promote anastomotic mucosa, reduce the incidence of occlusion of anastomotic again, significantly improve the suc-cess rate of surgery.

关 键 词：鼻内窥镜 慢性泪囊炎 

分 类 号：R779.6[医药卫生—眼科]