经鼻内窥镜下泪囊鼻腔吻合术治疗急性泪囊炎的疗效观察及对术后出血的影响  

Therapeutic effect of nasal endoscopic dacryocystorhinostomy on acute dacryocystitis and its influece on postoperative bleeding

作　　者：孙元强[1] 王晓峰[1] SUN Yuanqiang;WANG Xiaofeng(Department of Ophthalmology,Huzhou First People's Hospital in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第一人民医院眼科,浙江湖州313000

出　　处：《中国现代医生》2020年第21期71-74,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019PY079)。

摘　　要：目的探讨急性泪囊炎症状采用鼻内窥镜下行泪囊鼻腔吻合无创手术治疗的临床疗效,并分析其对术后患者出血的影响。方法从我院在2016年1月1日~2017年6月1日收治的急性泪囊炎患者中,筛选出其中46例(46例/眼)作为本临床研究对象,按照急性泪囊炎临床症状的表现分为观察组(34例/眼),主要临床表现为泪囊区皮肤红肿)和对照组(12眼,主要临床表现为脓肿自行破渍)。随访3个月~2年,观察两组患者实施经鼻内窥镜下泪囊鼻腔吻合术治疗后的疼痛及出血情况,分析手术治疗的效果。结果随访发现,观察组存在术后出血1眼。在术中使用一次性外科手术引流管的情况中,观察组有29眼使用一次性外科手术引流管,使用率为85.29%;对照组有10眼使用一次性外科手术引流管,使用率为83.33%;两组患者术中使用一次性外科手术引流管的情况比较,差异无统计学意义(P>0.05)。观察组有效率为88.24%,对照组有效率为91.67%,两组患者数据比较,差异无统计学意义(χ^2=0.108,P=0.743)。结论在鼻内窥镜下行泪囊鼻腔吻合无创手术治疗急性泪囊炎症状具有良好的临床疗效,不仅可提高手术有效率,还不影响泪囊区皮肤外伤瘢痕形成的外观情况,术后出血情况也少,是一种临床治疗的有效方法。Objective To explore the clinical efficacy of nasal endoscopic dacryocystorhinostomy non-invasive surgery for acute lacrimal sac inflammation,and to analyze its effect on postoperative bleeding.Methods From the patients with acute dacryocystitis admitted to our hospital from January 1,2016 to June 1,2017,46 patients(46 cases/eyes)were selected as the clinical study subjects.According to the clinical symptoms of acute dacryocystitis,the patients were divided into observation group(34 cases/eyes),with mainly clinical manifestations of redness in the lacrimal sac area)and control group(12 cases)eyes,with mainly clinical manifestations of abscess self-breaking).The patients were followed up for 3 months to 2 years.The pain and bleeding of the patients who underwent endoscopic dacryocystorhinostomy were observed.The effect of surgical treatment was analyzed.Results Follow-up revealed that there was 1 postoperative bleeding in the observation group.In the case of using a disposable surgical drainage tube during surgery,29 eyes in the observation group used a disposable surgical drainage tube,with the use rate of 85.29%.In the control group,10 eyes used a disposable surgical drainage tube,with the use rate of 83.33%.There was no statistically significant difference in the use of disposable surgical drainage tubes(P>0.05).The effective rate of the observation group was 88.24%,and the effective rate of the control group was 91.67%.The data of the two groups were compared,There was no statistically significant difference(χ^2=0.108,P=0.743).Conclusion Non-invasive surgery of dacryocystorhinostomy with nasal endoscopy has a good clinical effect in treating acute lacrimal sac inflammation.It not only improves the efficiency of surgery,but also does not affect the appearance of skin scarring in the lacrimal sac area,with less postoperative bleeding.It is an effective method for clinical treatment.

关 键 词：急性泪囊炎 鼻内窥镜 泪囊鼻腔吻合术 疗效 术后出血 皮肤瘢痕 

分 类 号：R777[医药卫生—眼科]