“清毒排瘀”冲洗液在鼻腔泪囊吻合术术腔处理中的随机对照实验  

The Randomised controued exqeriment for“Qiug-Du Pai-yu”in nasal endoscopic dacryocy storhinostomy for curing chynic dacryocysticis

作　　者：刘新泉[1] 苏晶[1] 

机构地区：[1]上海中医药大学附属龙华医院眼科,上海200072

出　　处：《中国中西医结合耳鼻咽喉科杂志》2016年第3期190-193,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨在经鼻内镜鼻腔泪囊吻合术中及术后应用"清毒排瘀"冲洗液冲洗治疗慢性泪囊炎的临床疗效。方法将39例慢性泪囊炎患者分为治疗组和对照组。治疗组在经鼻内窥镜鼻腔泪囊吻合术中应用明胶海绵浸润"清毒排瘀"冲洗液后填充吻合口,对照组手术方法同治疗组,但术中不填塞中药明胶海绵;术后随访12月,治疗组随访中采用"清毒排瘀"冲洗液冲洗泪道。对照组采用地塞米松5mg+庆大霉素4万u的生理盐水冲洗泪道。观察两组患者的一般手术情况、术后疗效,术后泪道通畅情况,术后鼻内镜下测量造瘘口面积,检查鼻腔结构恢复情况。结果对照组有效(治愈+好转)12例,有效率66.6%;治疗组有效(治愈+好转)20例,有效率95.2%。治疗组手术成功率明显高于对照组,其差异有统计学意义(χ2=4.081,P<0.05)。术后1、3、6、12月时治疗组和对照组造瘘口大小比较,治疗组造瘘口明显大于对照组,差异有统计学意义(P<0.05)。治疗组平均在术后6.6±2.7周时造瘘口粘膜上皮化;对照组平均在术后8.7±3.4周时造瘘口粘膜上皮化;治疗组造瘘口黏膜上皮化明显早于对照组(t=-2.11,P<0.05)。结论在经鼻内镜鼻腔泪囊吻合术中应用中药填充及术后冲洗泪道,能有效提高手术成功率,减少术后吻合口闭锁,加快造瘘口粘膜上皮化。可作为术腔处理的一种简便、安全有效的治疗方式。Objective To discuss the clinical effect of＂Qing-Du Pai-Yu＂in nasal endoscopic dacryocystorhinostomy for curing chronic dacryocystitis. Methods Totally 39 patients with chronic dacryocystitis were divided into treatment group and control group;the patients in treatment group received traditional Chinese medicine in and after surge. While the patients in control group receive Dexamethasone ＋gentamicin. After 12 months follow surge the patient was observed, and the area of ostomy with asalendoscope and mycteric recovery was examined. Results Of all 21 eyes in treatment group, 20 eyes were cured, the cure rate was 95.2%; In control group, 12 eyes were cured, the cure rate was 66.6%; a significant difference was found in cure rate between two groups（P 0.05）.Conclusion The application of traditional Chinese medicine in nasal endoscopic dacryocystorhinostomy is a simple, safe and effective way to treat the chronic dacryocystitis, because it possesses the advantages of few scar of face, small atresia of ostomy and high successful rate.

关 键 词：慢性泪囊炎 鼻内镜鼻腔泪囊吻合术 “清毒排瘀” 

分 类 号：R779.6[医药卫生—眼科]