同期鼻内镜改良路径术联合泪囊鼻腔造孔术治疗慢性鼻-鼻窦炎合并慢性泪囊炎效果  

Effect of Simultaneous Modified Nasal Endoscopic Pathway Combined with Intranasal Endoscopic Dacryocystorhinostomy in the Treatment of Chronic Rhinosinusitis Combined with Chronic Dacryocystitis

作　　者：张超兰[1] 周长华[1] 唐刘霞 夏晨 ZHANG Chaolan;ZHOU Changhua;TANG Liuxia;XIA Chen(Department of Otolaryngology Head and Neck Surgery,Dazhou Central Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中心医院耳鼻咽喉头颈外科,四川达州635000

出　　处：《临床误诊误治》2023年第5期119-124,共6页Clinical Misdiagnosis & Mistherapy

基　　金：2020年四川省卫生健康科研课题立项项目(20PJ311)。

摘　　要：目的探讨同期鼻内镜改良路径术联合鼻内镜泪囊鼻腔造孔术(IEDCR)治疗慢性鼻-鼻窦炎(CRS)合并慢性泪囊炎(CD)的效果。方法选取2020年1月—2022年6月收治的CRS合并CD 82例,根据手术方法不同将其分为同期组和分期组2组各41例。2组分别实施同期或分期鼻内镜改良路径术联合IEDCR。比较2组手术一般情况,术前和术后视觉模拟评分法(VAS)评分和嗅觉功能分级,术前和术后1、3个月鼻黏膜纤毛输送率、清除率及鼻腔鼻窦结局测试-20(SNOT-20)评分、CD生活质量量表(DQOLS)评分,以及随访6个月并发症和复发率。结果同期组手术时间和住院时间短于分期组(P<0.01)。鼻部、眼部症状VAS评分和嗅觉功能分级,术后2组低于术前或较术前改善(P<0.01,P<0.05),但术前和术后2组比较差异无统计学意义(P>0.05)。鼻黏膜纤毛输送率、清除率和DQOLS评分2组术后1和3个月均高于术前(P<0.05),但2组术前和术后1、3个月比较差异无统计学意义(P>0.05);SNOT-20评分2组术后1和3个月均低于术前(P<0.05),但2组术前和术后1、3个月比较差异无统计学意义(P>0.05)。随访6个月,2组并发症总发生率和复发率比较差异无统计学意义(P>0.05)。结论同期和分期鼻内镜改良路径术联合IEDCR治疗CRS合并CD患者均能取得理想近中期效果,安全性较好,但前者可进一步缩短手术时间,促进术后恢复。Objective To investigate the effect of simultaneous modified nasal endoscopic pathway combined with intranasal endoscopic dacryocystorhinostomy(IEDCR)in the treatment of chronic rhinosinusitis(CRS)with chronic dacryocystitis(CD).Methods A total of 82 patients with CRS complicated with CD admitted from January 2020 to June 2022 were selected and divided into two groups according to different surgical methods:simultaneous group and staged group,with 41 cases in each group.The two groups underwent simultaneous or staged modified nasal endoscopic pathway combined with IEDCR.Preoperative and postoperative visual analog scale(VAS)scores and olfactory function grades were compared between the two groups.Preoperative and postoperative nasal mucociliary delivery rate,clearance rate and sino-nasal outcome test 20(SNOT-20)scores,chronic dacryocystitis quality of life scale(DQOLS)scores were compared between the two groups.Complication and recurrence rates at 6 months after follow up were compared.Results The duration of operation and length of hospital stay in the simultaneous group were shorter than those in the staged group(P<0.01).VAS score and olfactory function grade of nose and eye symptoms in the two groups were lower or improved after surgery(P<0.01,P<0.05),but there was no statistical significance between the two groups before and after surgery(P>0.05).The nasal mucociliary delivery rate,clearance rate and DQOLS score of the two groups were higher than those before surgery at 1 and 3 months after surgery(P<0.05),but there was no significant difference between the two groups before surgery and at 1 and 3 months after surgery(P>0.05).SNOT-20 scores at 1 and 3 months after surgery were lower than those before surgery(P<0.05),but there was no significant difference between the two groups before surgery and at 1 and 3 months after surgery(P>0.05).At 6 months after follow-up,there was no significant difference in the total incidence and recurrence rate of complications between the two groups(P>0.05).Conclusion Simultaneo

关 键 词：鼻-鼻窦炎 泪囊炎 鼻内镜改良路径术 泪囊鼻腔造孔术 同期手术 视觉模拟评分法 腔鼻窦结局测试-20 慢性泪囊炎生活质量量表 

分 类 号：R765[医药卫生—耳鼻咽喉科]