鼻内镜下泪囊鼻腔造口术与泪道逆行置管术治疗鼻泪管阻塞的临床对比研究  

Clinical comparative study of endoscopic dacryocystorhinostomy and lacrimal duct retrograde tube insertion in the treatment of nasolacrimal duct obstruction

作　　者：张芳 邹莹 王亚乐 彭树文[1] 刘洁梅[1] ZHANG Fang;ZOU Ying;WANG Ya-le(Department of Otolaryngology Head and Neck Surgery,Guangzhou Panyu District Traditional Chinese Medicine Hospital,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中医院耳鼻咽喉头颈外科,511400

出　　处：《中国实用医药》2024年第11期71-74,共4页China Practical Medicine

基　　金：广州市番禺区科技计划医疗卫生项目-临床医学研究类(项目编号:2021-Z04-011)。

摘　　要：目的 对比鼻内镜下泪囊鼻腔造口术与泪道逆行置管术治疗鼻泪管阻塞(NLDO)的临床效果。方法 50例鼻泪管阻塞患者,按就诊天数的单双号分为A组(单号日期, 25例)、B组(双号日期,25例)。A组实施鼻内镜下泪道逆行置管术, B组实施鼻内镜下泪囊鼻腔造口术。对比两组手术相关指标、并发症发生率、复发率。结果 A组手术时间(29.25±3.18)min、在院时间(0.85±0.23)d明显短于B组的(51.74±3.26)min、(4.47±1.26)d,出血量(5.03±1.06)ml少于B组的(46.45±11.12)ml(P<0.05)。A组并发症发生率(4.00%)低于B组(24.00%),但术后1年复发率(28.00%)高于B组(4.00%)(P<0.05)。结论 鼻内镜下泪道逆行置管术治疗鼻泪管阻塞较泪囊鼻腔造口术具有手术时间短、操作较容易、出血量少等优势,而鼻内镜下泪囊鼻腔造口术较泪道逆行置管术则更有利于预防术后复发。Objective To compare the clinical effect of endoscopic dacryocystorhinostomy and lacrimal duct retrograde tube insertion in the treatment of nasolacrimal duct obstruction(NLDO).Methods 50 patients with nasolacrimal duct obstruction were divided into group A(single number date,25 cases)and group B(even number date,25 cases)according to the odd-even number of days of treatment.Group A underwent endoscopic retrograde lacrimal duct insertion,and group B underwent endoscopic dacryocystorhinostomy.The operation related indexes,complication rate and recurrence rate were compared between the two groups.Results The operation time and hospital stay of group A were(29.25±3.18)min and(0.85±0.23)d,which were significantly shorter than(51.74±3.26)min and(4.47±1.26)d of group B;group A had less blood loss of(5.03±1.06)ml than(46.45±11.12)ml in group B(P<0.05).The incidence of complications in group A(4.00%)was lower than that in group B(24.00%),but 1-year postoperative recurrence rate(28.00%)was higher than that in group B(4.00%)(P<0.05).Conclusion Endoscopic lacrimal duct retrograde tube insertion for nasolacrimal duct obstruction has the advantages of shorter operation time,easier operation,and less bleeding than dacryocystorhinostomy,whereas endoscopic acryocystorhinostomy is more favorable to the prevention of postoperative recurrence than lacrimal duct retrograde tube insertion.

关 键 词：鼻泪管阻塞 鼻内镜 泪囊鼻腔造口术 泪道逆行置管术 临床疗效 对比 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]