鼻中隔偏曲对鼻腔内窥镜下泪囊鼻腔吻合术疗效的影响  

Effect of nasal septum deviation on the curative effect of endonasal endoscopic dacryocystorhinostomy

作　　者：张懿[1] 杨华[1] 杨晓钊[1] 郑璇[1] 王博[1] Yi Zhang;Hua Yang;Xiao-Zhao Yang;Xuan Zheng;Bo Wang(Department of Ophthalmology, Xi'an No.1 Hospital, Shaanxi Institute of Ophthalmology, Shaanxi Key Laboratory of Ophthalmology, Clinical Research Center for Ophthalmology Diseases of Shaanxi Province, Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an 710002, Shaanxi Province, China)

机构地区：[1]中国陕西省西安市第一医院眼科,陕西省眼科研究所,陕西省眼科学重点实验室,陕西省眼科疾病临床医学研究中心,西北大学附属第一医院眼科,710002

出　　处：《国际眼科杂志》2021年第1期174-177,共4页International Eye Science

基　　金：陕西省社会发展科技攻关项目(No.2016SF-328)。

摘　　要：目的:探讨鼻中隔偏曲对鼻腔内窥镜下泪囊鼻腔吻合术(EES-DCR)疗效的影响。方法:收集我院2017-06/2019-05收治的慢性泪囊炎患者84例84眼,依据术前鼻内窥镜检查是否有鼻中隔偏曲分组,A组42例42眼无鼻中隔偏曲,B组42例42眼伴有轻、中度鼻中隔偏曲。两组患者均于全身麻醉下行EES-DCR术,对比两组围手术期治疗指标,术后随访6mo评价疗效及鼻腔黏连情况。结果:B组患者手术时间、术中出血量(69.9±13.1min、51.8±16.4mL)均较A组(53.4±11.7min、24.9±12.0mL)多(P<0.05),而住院时间两组无差异(P>0.05)。随访6mo,A组有效率86%,B组有效率71%,两组有效率无差异(P>0.05);A组患者均未发生鼻腔黏连,B组鼻腔黏连发生率为12%,但两组无差异(P>0.05)。结论:慢性泪囊炎合并轻、中度鼻中隔偏曲者,若不伴有鼻腔功能障碍可不在Ⅰ期行鼻中隔偏曲矫正术,单行EES-DCR即可取得较好的效果。AIM:To explore the effect of nasal septum deviation(NSD)on the curative effect of endonasal endoscopic dacryocystorhinostomy(EES-DCR).METHODS:Totally 84 patients(84 eyes)who have been diagnosed with chronic dacryocystitis in our hospital from June 2017 to May 2019 were collected and then the patients were divided them into two groups according to whether NSD existed through the preoperative nasal endoscopy.Group A included 42 patients(42 eyes)who had no NSD while Group B included 42 patients(42 eyes)who had NSD(mild or moderate).The EES-DCR was performed under general anesthesia in both groups.The preoperative treatment indexes,evaluative efficacy after 6mo follow up and nasal adhesion were compared between the two groups after operation.RESULTS:The operation time and intraoperative blood loss of group B(69.9±13.1min,51.8±16.4mL)exceeded group A(53.4±11.7min,24.9±12.0mL)respectively(P<0.05),while the hospitalization time between two groups showed no difference(P>0.05).Follow up for 6mo:the effective rate of group A was 86%while group B was 71%(P>0.05);No nasal adhesion was found in group A while 12%incidence existed in group B,with no difference between the two groups(P>0.05).CONCLUSION:Patients who have chronic dacryocystitis combined with mild or moderate NSD do not need to perform a septoplasty simultaneously if the symptom does not accompany by nasal dysfunction.Only by performing the EES-DCR can achieve a quite good result.

关 键 词：鼻腔内窥镜下泪囊鼻腔吻合术 鼻中隔偏曲 慢性泪囊炎 疗效 泪器 外科学 

分 类 号：R779.6[医药卫生—眼科]