新型鼻用敷料在泪囊鼻腔吻合术中的应用  

The application of a new nasal dressing in entranasal endoscopic dacryocystorhinostomy

作　　者：王媛[1] 叶琳[1] 彭云[1] 郭慧[1] 

机构地区：[1]深圳市眼科医院暨南大学附属深圳眼科医院泪器病科深圳眼科学重点实验室,518040

出　　处：《中华眼外伤职业眼病杂志》2016年第2期100-104,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨一种新型自交联透明质酸水凝胶鼻用敷料（商品名PureRegen Gel Sinus，简称敷料S）在鼻内镜下泪囊鼻腔吻合术中应用的效果及安全性。方法选取32位双侧鼻内镜下行泪囊鼻腔吻合术的慢性泪囊炎患者，随机一侧使用敷料S作为治疗组，另一侧不使用该敷料作为对照组，术后1、2、4、8、12周评估其效果。结果30位患者完成了本项研究。在术后的随访中，术后4、8周时治疗组上皮化的程度优于对照组，差异有统计学意义（Z=2．21，P=0．027；Z=2．642，P=0．008）。治疗组水肿程度较对照组轻，且水肿消退速度较对照组快，但是两组的差异无统计学意义（P〉0．05）。术后12周阻塞性粘连、息肉的发生及手术治愈率两组的差异无统计学意义（P〉0．05）。结论敷料S在鼻内镜下鼻腔泪囊吻合术中使用是安全的，促进了术后上皮化过程。Objective To assess the safety and efficacy of self-crosslinked hyaluronic acid hydrogel （PureRegen Gel Sinus） as a postoperative nasal dressing in the entranasal endoscopic dacryocystorhinostomy （EES-DCR）. Methods Thirty-two patients with primary chronic dacryocystitis （PCD） underwent bilateral EES-DCR in our hospital. The randomly selected right or left lacrimal ostium was filled with PureRegen Gel Sinus （dressing S） and the other side as the control group received no dressing S. Patients were followed up for 12 weeks. The mueosal epithelialization of the wound, synechiae, edema, granuloma and the success rate of ostial patency were compared between the two groups. Results Thirty patients completed the study. The dressing S group showed significantly better results than the control group in the degree of the mucosal epithelialization at 4 or 8 weeks after the operation （ Z = 2. 21, P = 0. 027 ; Z = 2. 642, P = 0. 008 ）. The degree of tumescence in the dressing S group was less and the speed of detumescence was faster compared with that in the control group, but the differences were not statistically significant （ P 〉 0.05 ）. Whereas there were no statistically significant differences between the two groups in synechiae, granuloma and the success rate of ostial patency at 12 weeks postoperatively （ P 〉 0.05 ）. Conclusion The dressing S can facilitate mucosal epithelialization and is a safe nasal dressing in EES-DCR.

关 键 词：泪囊鼻腔吻合术 鼻内镜下 经鼻腔 泪囊炎 慢性 鼻用敷料 自交联透明质酸水凝 胶 疗效 

分 类 号：R779.6[医药卫生—眼科]