中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2015年
7期
497-500
,共4页
泪囊鼻腔吻合术,鼻内镜下%泪囊炎,慢性%泪囊鼻腔引流支架
淚囊鼻腔吻閤術,鼻內鏡下%淚囊炎,慢性%淚囊鼻腔引流支架
루낭비강문합술,비내경하%루낭염,만성%루낭비강인류지가
Dacryocystorhinostomy,nasal endoscopic%Dacyocystitis,chronic%Nasolacrimal drainage stent
目的：评价鼻内镜下泪囊鼻腔吻合术( En-DCR)联合泪囊鼻腔引流支架( NLDS)置入治疗慢性泪囊炎的临床疗效。方法采用临床随机对照研究。慢性泪囊炎220例随机分成两组：支架组和对照组各110例。两组均行En-DCR,但支架组联合NLDS置入。术后随访6个月,比较两组患者手术成功率以及肉芽组织和瘢痕组织形成情况。结果最终完成随访者190例(216只眼),包括支架组100例(113只眼)和对照组90例(103只眼)。术后3个月,支架组手术成功率91.2%(103/113)高于对照组80.6%(83/103)(χ2=5.032,P=0.025)；支架组吻合口肉芽组织形成者占2.7%(3/113)低于对照组的9.7%(10/103)(χ2=4.740,P=0.029)；支架组瘢痕组织形成者占7.1%(8/113)低于对照组的16.5%(17/103)(χ2=4.677,P=0.031)。经复诊鼻内镜下换药,清除肉芽、瘢痕组织并置管。随访至术后6个月,支架组手术成功率98.2%(111/113),而对照组为96.1%(99/103),两者比较差异无统计学意义(χ2=0.280,P=0.596)。结论 En-DCR联合NLDS置入能够减少肉芽组织和瘢痕组织形成,提高早期手术成功率,从而减少鼻内镜下随访换药次数。
目的：評價鼻內鏡下淚囊鼻腔吻閤術( En-DCR)聯閤淚囊鼻腔引流支架( NLDS)置入治療慢性淚囊炎的臨床療效。方法採用臨床隨機對照研究。慢性淚囊炎220例隨機分成兩組：支架組和對照組各110例。兩組均行En-DCR,但支架組聯閤NLDS置入。術後隨訪6箇月,比較兩組患者手術成功率以及肉芽組織和瘢痕組織形成情況。結果最終完成隨訪者190例(216隻眼),包括支架組100例(113隻眼)和對照組90例(103隻眼)。術後3箇月,支架組手術成功率91.2%(103/113)高于對照組80.6%(83/103)(χ2=5.032,P=0.025)；支架組吻閤口肉芽組織形成者佔2.7%(3/113)低于對照組的9.7%(10/103)(χ2=4.740,P=0.029)；支架組瘢痕組織形成者佔7.1%(8/113)低于對照組的16.5%(17/103)(χ2=4.677,P=0.031)。經複診鼻內鏡下換藥,清除肉芽、瘢痕組織併置管。隨訪至術後6箇月,支架組手術成功率98.2%(111/113),而對照組為96.1%(99/103),兩者比較差異無統計學意義(χ2=0.280,P=0.596)。結論 En-DCR聯閤NLDS置入能夠減少肉芽組織和瘢痕組織形成,提高早期手術成功率,從而減少鼻內鏡下隨訪換藥次數。
목적：평개비내경하루낭비강문합술( En-DCR)연합루낭비강인류지가( NLDS)치입치료만성루낭염적림상료효。방법채용림상수궤대조연구。만성루낭염220례수궤분성량조：지가조화대조조각110례。량조균행En-DCR,단지가조연합NLDS치입。술후수방6개월,비교량조환자수술성공솔이급육아조직화반흔조직형성정황。결과최종완성수방자190례(216지안),포괄지가조100례(113지안)화대조조90례(103지안)。술후3개월,지가조수술성공솔91.2%(103/113)고우대조조80.6%(83/103)(χ2=5.032,P=0.025)；지가조문합구육아조직형성자점2.7%(3/113)저우대조조적9.7%(10/103)(χ2=4.740,P=0.029)；지가조반흔조직형성자점7.1%(8/113)저우대조조적16.5%(17/103)(χ2=4.677,P=0.031)。경복진비내경하환약,청제육아、반흔조직병치관。수방지술후6개월,지가조수술성공솔98.2%(111/113),이대조조위96.1%(99/103),량자비교차이무통계학의의(χ2=0.280,P=0.596)。결론 En-DCR연합NLDS치입능구감소육아조직화반흔조직형성,제고조기수술성공솔,종이감소비내경하수방환약차수。
Objective To evaluate the clinical efficacy of dacryocystorhinostomy combined with nasolacrimal drainage stent ( NLDS) implantation under endoscope for the treatment of chronic dacyocystitis. Methods It was a prospective randomized control study. Two hundred and twenty patients with chronic dacryocystitis were randomly divided into two groups: stent group and control group with 110 cases in each group. All patients of two groups underwent endonasal endoscopic dacryocystorhinostomy (En-DCR), but patients in stent group received combined NLDS implantation. Patients were followed up for 6 months. The surgical success rates of En-DCR, occurrence of granulation tissue and the proliferation of scar tissue were compared between two groups. Results One hundred and ninety patients ( 216 eyes ) were ultimately observed including 100 cases (113 eyes) in stent group and 90 cases (103 eyes) in control group. The surgical success rate of stent group was 91. 2%(103/113) which was higher than that in control group 80. 6%(83/103) (χ2 =5. 032,P=0. 025) three months after the surgery. Granulation formation rate at the ostium margins of stent group was 2. 7%(3/113) which was lower than that 9. 7% (10/103) in control group and scarring formation rate of stent group was 7. 1% (8/113) which was also lower than that 16. 5%(17/103) in control group. After the revision surgery along with silicone tube intubation, the final success rate at 6 months after the surgery was 98. 2% (111/113) for stent group and 96. 1% (99/103) for control group. The difference was not statistically significant (P>0.05). Conclusion En-DCR combined with NLDS implantation reduces the formation of granulation and scar tissue, which improves primary success rate of En-DCR and reduces the reprocessing frequency under endoscope.
