鼻内镜下泪囊鼻腔吻合术导尿管应用于吻合口的临床疗效  

Clinical effect of tobramycin dexamethasone eye ointment combined with catheter in endoscopic dacryocystorhinostomy

作　　者：胡海林 李一敏 王俊芳 施沃栋[1] Hu Hailin;Li Yimin;Wang Junfang;Shi Wodong(Department of Ophthalmology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院眼科,上海市眼眶病眼肿瘤重点实验室,200011

出　　处：《临床眼科杂志》2021年第3期247-251,共5页Journal of Clinical Ophthalmology

摘　　要：目的评价在经鼻内镜下泪囊鼻腔吻合术中应用导尿管于泪囊黏膜和鼻黏膜吻合口的临床疗效。方法采用回顾性分析,2019年1月—2019年12月,选取符合条件的慢性泪囊炎患者,共80例(80只眼)。随机分为观察组和对照组,两组均行经鼻内镜下泪囊鼻腔吻合术。观察组39例,以妥布霉素地塞米松眼膏覆盖吻合口,8号导尿管支撑泪囊黏膜和鼻黏膜吻合口,对照组41例为妥布霉素地塞米松眼膏覆盖吻合口。比较两组术中吻合口形成所用时间、术中出血量。术后随访6个月,比较两组荧光素消失试验时间,术后并发症,术后效果和术后有效率。结果全部80名患者完成随访,男女性别比例、年龄、病程、眼别差异无统计学意义(P>0.05)。两组患者在术中吻合口形成所用时间和出血量差异有统计学意义(P<0.001)。术后6个月随访,两组患者在并发症(黏膜粘连和肉芽形成)比较,差异无统计学意义(P>0.05)。观察组在荧光素消失试验时间明显短于对照组,两组比较差异有统计学意义(P<0.001)。观察组临床总有效率97.4%(38/39)明显高于对照组78%(32/41),两组比较差异有统计学意义(P<0.005)。结论妥布霉素地塞米松眼膏联合导尿管应用虽然手术时间略长,术中出血量略多,但是术后能够促进吻合口愈合,使泪液引流更快,提高手术成功率,经济高效。Objective To evaluate the clinical effect of tobramycin dexamethasone eye ointment combined with catheter in endoscopic dacryocystorhinostomy.Methods A total of 80 patients(80 eyes)with chronic dacryocystitis who underwent endoscopic dacryocystorhinostomy in our hospital from January 2019 to December 2019 were selected for this retrospective analysis.The patients were randomly divided into two groups:the observation group(39 eyes)and the control group(41 eyes).In the observation group,the anastomotic stoma was covered with tobramycin and dexamethasone eye ointment,and the No.8 catheter was used to support the dacryocystal mucosa and nasal mucosa anastomosis.In the control group,the anastomotic stoma was covered with tobramycin and dexamethasone eye ointment.The time of anastomotic formation and the amount of bleeding were compared between the two groups.After 6 months of follow-up,the time of fluorescein disappearance test,postoperative complications,postoperative effect and postoperative efficiency rate were compared between the two groups.Results All 80 patients completed the follow-up.There was no statistically significant difference in gender ratio,age,course of disease or eye laterality(P>0.05).There were significant differences in the time of anastomotic formation and amount of bleeding between the two groups(P<0.001).After 6 months of follow-up,there was no significant difference between the two groups in the complications(mucosal adhesion and granulation formation)(P>0.05).The time of fluorescein disappearance test in the observation group was significantly shorter than that in the control group,and there was statistical difference between the two groups(P<0.001).The total clinical effective rate of the observation group was 97.4%(38/39),which was significantly higher than t the control group(78%;32/41).There was statistical difference between the two groups(P<0.05).Conclusions Despite of relatively longer operation time and larger amount of bleeding,Tobramycin dexamethasone eye ointment combined with cat

关 键 词：导尿管 妥布霉素地塞米松眼膏 鼻内镜 泪囊鼻腔吻合术 

分 类 号：R779.6[医药卫生—眼科]