纳吸棉在鼻内镜下鼻腔泪囊吻合术中的应用观察  

Effect evaluation of Nasopore packing in endoscopic dacryocystorhinostomy

作　　者：王芳芳[1] 刘荣[1] 马剑晴[1] 艾俐[1] 李莉[1] Wang Fangfang;Liu Rong;Ma Jianqing;Ai Li;Li Li(Department of Ophthalmology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,武汉430000

出　　处：《临床眼科杂志》2020年第2期177-179,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨纳吸棉在鼻内镜下鼻腔泪囊吻合术(En-DCR)中的应用效果。方法采用临床随机对照研究,将110例(118只眼)鼻泪管阻塞患者,按术后首次复诊时间分为A、B两组,每组各59只眼。两组手术方式均为En-DCR,术中均使用纳吸棉覆盖泪囊鼻腔吻合口,并填塞鼻腔。A组患者术后2周首次清理鼻腔,B组术后4周首次复诊,之后毎2周复诊1次直至术后3个月。比较两组纳吸棉吸收、吻合口通畅及黏膜上皮化情况。结果术后第2周纳吸棉成糊状,易吸除,第4周纳吸棉呈硬壳状,部分已吸收。随访至术后3个月,两组吻合口通畅率及黏膜上皮化完成率无显著差异(P>0.05)。结论纳吸棉可应用于En-DCR术中吻合口及鼻腔的填压,于术后2周或4周清理鼻腔均可,复诊时间可根据患者吻合口等情况决定,给予每位患者提供个性化治疗,提高手术疗效,保证患者满意度。Objective To investigate the effect of nasopore in endoscopic dacryocystorhinostomy(En-DCR).Methods A total of 110 patients(118 eyes)with chronic dacryocystitis were selected in this study.Based on the time of first postoperative visit,patients were randomly divided into group A and group B with 59 eyes in each group.All patients underwent En-DCR,and nasopore was implanted to cover the dacryocystorhinal anastomosis and pack the nasal cavity.The nasal cavities of patients in group A were firstly cleared at 2 weeks after the surgery,while patients in group B were re-examined for the first time at 4 weeks after the surgery.Patients were followed up once every two weeks,until 3 months after the surgery.The absorption of nasopore,anastomotic stoma and mucosal epithelialization were observed and compared between the two groups.Results Nasopore was mushy and easy to be cleared at 2 weeks post-operatively.At 4 weeks after the surgery,nasopore was crusted and partially absorbed.There was no significant difference in anastomotic patency and mucosal epithelialization between the two groups(P>0.05).Conclusions Nasopore can be applied to pack the anastomotic stoma and nasal cavity in En-DCR.The nasal cavity cleaning can be performed at 2 or 4 weeks after the surgery and the time can be determined according to the anastomotic condition.This personalized treatment method will not affect the surgical effect,and would provide better effect to improve the comfort level and treatment satisfaction of patients.

关 键 词：鼻泪管阻塞 鼻腔泪囊吻合术 鼻内镜 纳吸棉 鼻腔填塞 

分 类 号：R73[医药卫生—肿瘤]