超声骨刀辅助下泪囊鼻腔吻合术联合黏膜四瓣吻合治疗慢性泪囊炎的临床研究  

Clinical study of dacryocystorhinostomy combined with four-flap anastomosis assisted by piezoelectric osteotomy for the treatment of chronic dacryocystitis

作　　者：解传奇[1] 张令令[2] 马红[1] 冀书哲 Xie Chuanqi;Zhang Lingling;Ma Hong;Ji Shuzhe(Department of Ophthalmology,the First People’s Hospital of Shangqiu,Shangqiu 476000,China;Shangqiu Medical College,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院眼科,商丘476000 [2]商丘医学高等专科学校,商丘476000

出　　处：《中华眼外伤职业眼病杂志》2022年第11期834-839,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省医学科技攻关计划联合共建项目(2018020945)。

摘　　要：目的评价超声骨刀辅助下泪囊鼻腔吻合术联合黏膜四瓣吻合治疗慢性泪囊炎的效果。方法回顾性病例对照研究。分析商丘市第一人民医院2017年3月至2020年8月慢性泪囊炎61例(61眼)的临床资料。根据治疗方式将患者分为两组,超声骨刀制作骨孔联合黏膜四瓣吻合术27例(27眼)为骨刀组,传统咬骨钳制作骨孔联合黏膜两瓣吻合术34例(34眼)为对照组。术后随访3个月,对比两组的手术耗时、有效率及吻合口开放率。结果骨刀组手术耗时为(78.6±12.9)min,短于对照组的(107.5±15.6)min(t=7.75,P=0.001)。骨刀组有效率96.30%(26/27)优于传统组的73.53%(25/34)(χ^(2)=4.15,P=0.042)。骨刀组吻合口开放率为92.59%(25/27)优于传统组的70.59%(24/34)(χ^(2)=4.61,P=0.032)。结论超声骨刀辅助下泪囊鼻腔吻合术联合黏膜四瓣吻合治疗慢性泪囊炎可以缩短手术时间,提高术后成功率。Objective To evaluate the clinical efficacy of dacryocystorhinostomy combined with four-flap anastomosis assisted by piezolelectric osteotomy for the treatment of chronic dacryocystitis.Methods This was a retrospective case control study.The clinical data of 61 eyes of 61 patients with chronic dacryocystitis from Mar.2017 to Aug.2020 in the First People’s Hospital of Shangqiu were analyzed.These patients were divided into two groups based on the treatment methods.Twenty-seven eyes of 27 cases which the bone hole was made by piezoelectric osteotomy combined with four-flap anastomosis were included in the osteotomy group,and 34 eyes of 34 cases which the bone hole was made by traditional bone rongeur combined with two-flap anastomosis were included in the control group.They were followed up for 3 months.The operation time,effective rate and opening rate of stoma between the two groups were compared.Results The average operation time of patients in the osteotomy group was(78.6±12.9)minutes,which was shorter than the(107.5±15.6)minutes in the control group.There was significant difference between the two groups(t=7.75,P=0.001).At 3 months after operation,the effective rate in the piezosurgery group was 96.30%(26/27),which was better than the 73.53%(25/34)in the control group(χ^(2)=4.15,P=0.042).The opening rate of stoma in the osteotomy group was 92.59%(25/27),which was better than the 70.59%(24/34)in the control group(χ^(2)=4.61,P=0.032).Conclusion Dacryocystorhinostomy combined with four-flap anastomosis assisted by piezoelectric osteotomy for the treatment of chronic dacryocystitis can complete the fabrication of bone holes faster,but also shorten the operation time significantly and improve the postoperative success rate.

关 键 词：泪囊炎 慢性 骨刀 超声 四瓣吻合术 泪囊鼻腔吻合术 经皮肤 

分 类 号：R779.6[医药卫生—眼科]