鼻内镜下泪囊鼻腔造孔术与鼻外路径鼻腔泪囊吻合术治疗复发性泪囊炎疗效对比  

Comparison of the efficacy of endonasal and external dacryocystorhinostomy for recurrent dacryocystitis

作　　者：张丹 罗荣莹 钟兵[1] 杜进涛[1] 刘锋[1] 刘世喜[1] 刘亚峰[1] ZHANG Dan;LUO Rongying;ZHONG Bing;DU Jintao;LIU Feng;LIU Shixi;LIU Yafeng(Department of Otolaryngology Head and Neck Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Ophthalmology,Chengdu First People's Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西医院耳鼻咽喉头颈外科,四川成都610041 [2]四川省成都市第一人民医院眼科,四川成都610041

出　　处：《西部医学》2020年第9期1371-1375,共5页Medical Journal of West China

基　　金：四川省科技厅科技支撑计划项目(2014SZ0088)。

摘　　要：目的探讨鼻内镜下泪囊鼻腔造孔术(endonasal DCR)与鼻外路径鼻腔泪囊吻合术(external DCR)治疗复发性泪囊炎的疗效,以寻求优化的治疗方法。方法选取2013年12月~2017年12月间四川大学华西医院耳鼻咽喉头颅外科接受手术治疗的75例复发性泪囊炎患者行回顾性分析,其中鼻内镜下泪囊鼻腔造孔术(鼻内镜组)24例,鼻外路径鼻腔泪囊吻合术(鼻外路径组)51例。通过1∶1倾向评分匹配后,对每组20例配对良好的患者进行住院费用、术中出血量、手术时长、溢泪分数评估。结果鼻内镜组与鼻外路径组的住院费用差异有统计学意义(P<0.001)。术中出血量、手术时长两组比较差异无统计学意义(P>0.05)。溢泪分数在术后3个月、术后6个月两组比较差异均无统计学意义(P>0.05),但在术后12个月两组比较差异有统计学意义(P<0.05)。结论与鼻外路径鼻腔泪囊吻合术相比,鼻内镜下鼻腔泪囊造孔术对复发性泪囊炎患者的溢泪有较好的缓解效果,可作为治疗复发性泪囊炎的首选方法。Objective To observe and compare the efficacy of endonasal dacryocystorhinostomy(external DCR)and external dacryocystorhinostomy(endonasal DCR)for the treatment of recurrent dacryocystitis.Methods From December 2013 to December 2017,75 patients with recurrent dacryocystitis who received endonasal DCR versus external DCR treatment in Department of Otolaryngology and head surgery,West China Hospital of Sichuan University,were retrospectively analyzed.There were 24 cases in endonasal DCR group and 51 cases in external DCR group.20 patients in each group were evaluated for hospitalization expenses,intraoperative blood loss,operation duration and tear discharge score.Results Significant differences were observed in hospital costs(median,9264.3 vs.4703.2 RMB,P<0.001).There was no significant difference of the duration of surgery(median,60.0 vs.45.0 minutes,P=0.057)or the volume of intraoperative hemorrhage(median,55.0 vs.40.0 mL,P<0.436).There was no significant difference of epiphora score between endonasal DCR and external DCR in 3 months(median,1.0 vs.1.0,P=0.944),6 months(median,1.0 vs.1.0,P=0.918)but showed significant difference at 12 months(median,1.0 vs.2.0,P=0.041).Conclusion endonasal DCR was shown better results in relieving epiphora in patients with recurrent dacryocystitis when compared with external DCR and may be a priority method for the dacryocystitis.

关 键 词：复发性泪囊炎 鼻内镜下泪囊鼻腔造孔术 鼻外路径鼻腔泪囊吻合术 倾向得分匹配 溢泪 

分 类 号：R777.23[医药卫生—眼科]