鼻内镜下鼻腔泪囊吻合联合新型支架治疗慢性泪囊炎的效果  

Effect of nasal endoscopic sacanastomosis combined with a novel stent in treatment of chronic dacryocystitis

作　　者：李雪娟[1] 杨倩倩[2] 庞长安 刘德成[2] LI Xue-juan;YANG Qian-qian;PANG Chang-an;LIU De-cheng(Department of Otolaryngology,Zhengzhou the Seventh People's Hospital,Zhengzhou 450016,China;Department of Ophthalmology,Zhengzhou the Seventh People's Hospital,Zhengzhou 450016,China)

机构地区：[1]郑州市第七人民医院耳鼻咽喉科,郑州450016 [2]郑州市第七人民医院眼科,郑州450016

出　　处：《医药论坛杂志》2023年第23期73-77,共5页Journal of Medical Forum

摘　　要：目的评价鼻内镜下鼻腔泪囊吻合联合新型支架治疗慢性泪囊炎的疗效及安全性。方法回顾分析郑州市第七人民医院2019年6月至2022年6月慢性泪囊炎行鼻内镜下鼻腔吻合术70例(70眼)的临床资料。患者随机分两组,对照组35例(35眼),鼻内镜鼻腔泪囊吻合口处放置纳吸棉;观察组35例(35眼),鼻内镜下鼻腔泪囊吻合处放置新型支架,术后24 h进行泪道冲洗,术眼左氧氟沙星滴眼液与普拉洛芬滴眼液连续使用2周,术侧鼻腔使用曲安奈德喷剂1月。对照组术后15天鼻内窥镜下清理鼻腔内未脱落的纳吸棉及血痂,禁擤鼻。观察术中和术后渗血,泪囊鼻腔吻合口形成及术后复发情况,进行密切随访,主要随访两组术后1个月、3个月的总有效率及吻合口面积。结果两组术后1个月总有效率(χ^(2)=0.07,P=0.263)与吻合口面积(χ^(2)=2.816,P=0.823)差异无统计学意义(P>0.05)。术后3、6个月的总有效率(χ^(2)=1.802,2.012;P=0.012,0.23)与吻合口面积(χ^(2)=2.886,3.112;P=0.021,0.032)均具有统计学意义(P<0.05)。结论鼻内镜下鼻腔泪囊吻合术吻合口置入新型支架,治疗效果显著。Objective To evaluate the efficacy and safety of nasal endoscopic dacryocystorhinostomy combined with anovel stent in the treatment of chronic dacryocystitis.Methods The clinical data of 70 patients(70 eyes)with chronic dacryo-cystitis undergoing nasal endoscopic dacryocystorhinostomy in Zhengzhou Seventh People's Hospital from June 2019 to June 2022 were retrospectively analyzed.Patients were randomly divided into two groups,control group 35 cases(35 eyes),na-sal endoscopic dacryocystorhinostomy was placed in the absorption cotton;In the observation group,35 cases(35 eyes)were placed a new stent at the nasal endoscopic dacryocystorhinostomy,and lacrimal duct irrigation was per-formed 24 hours after surgery.Levofloxacin eye drops and praprofen eye drops were used continuously for 2 weeks in the operative eye,and triamcinolone olone spray was used in the nasal cavity on the operative side for 1 month.In the control group,the remaining absorbent cotton and blood scab in the nasal cavity were cleared by nasal endoscope 15 days after op-eration,and nose blowing was forbidden.Intraoperative and postoperative blood infiltration,dacryocystonasal anastomosis formation and postoperative recurrence were observed,and close follow-up was conducted.The main follow-up was the total ef-fective rate and anastomosis area 1 month and 3 months after the operation of the two group.Results There was no signif-icant difference in total effective rate(χ^(2)=0.07,P=0.263)and anastomotic area(χ^(2)=2.816,P=0.823)between the two groups one month after surgery(P>0.05).The total effective rate at 3 and 6 months after operation(χ^(2)=1.802,2.012;P=0.012,0.23)and anastomotic area(χ^(2)=2.886,3.112;P=0.021,0.032)were statistically significant(P<0.05).Conclusion The placement of a new type of stent at the anastomotic site of nasal dacryocystorhnostomy under nasal end oscopy has a significant therapeutic effect.

关 键 词：新型支架 吻合口 泪囊炎 鼻内镜 

分 类 号：R779.6[医药卫生—眼科]