透明质酸钠在鼻腔泪囊吻合术中的应用

目的:探讨透明质酸钠在鼻腔泪囊吻合术中的作用及治疗效果。方法:选自我院2000-02/2008-02收治的慢性泪囊炎患者68例68眼,男16例16眼,女52例52眼,年龄24～65岁。所有患者于手术前点抗生素眼药水,呋嘛合剂滴鼻液滴鼻,请耳鼻喉科会诊排除鼻中隔偏曲,鼻窦炎,鼻腔息肉。随机分为治疗组(34例,鼻腔泪囊吻合术中应用了透明质酸钠)和对照组(34例,常规鼻腔泪囊吻合术)。分别于手术后1,2,3,7,14d;1,6,12mo观察鼻腔渗血及伤口恢复情况,泪道通畅程度,溢泪情况,对其疗效进行比较,并统计学处理。结果:手术后观察15mo,治疗组34眼,治愈(溢泪、流脓症状消失,冲洗泪道通畅)33眼;好转(症状减轻,冲洗泪道通畅,但仍有溢泪症状)1眼;无效(症状无缓解,冲洗时不通,有溢脓现象)0眼,治愈率97%。对照组34眼,治愈30眼,好转3眼,无效1眼,治愈率88%。结论:透明质酸钠应用于鼻腔泪囊吻合术,可减少手术后渗血,避免吻合口粘连,保持吻合口通畅状况,增加手术的成功率。

Observation of Sodium Hyaluronate in routine dacryocystorhinostomy

AIM:To evaluate the clinical effects of Sodium Hyaluronate(SH) used in operation of dacryocystorhinostomy. ·METHODS:This study included sixty-eight patients (age from 24 to 65) of chronic dacryocystitis who had been treated by the department of ophthalmology of our hospital between February 2000 and February 2008. There were 16 male patients (16 eyes),and 52 female patients (52 eyes).In this study. All patients used eyedrop and naristillae before operation,and had been consulted by E.N.T. Department to get rid of the diseases,such as deviation of nasal septum,nasalpolyp and nasosinusitis.They were divided into 2 groups at random. One group (34 patients) used Sodium Hyaluronia (SH) named treated group(No.1),the other group(34 patients)did not use SH named comparison group(No.2). Many conditions were observed and compared 1 day,2 days,3 days,1 week,2 weeks,1 months,6 months and 12 months after operation,such as seeping in nostril,renewing of cut,unobstructed degree of tractus lacrimalis,epiphora,etc. They were analyzed after observation statistically. ·RESULTS:All patients were observed for 1-2 years. In group No.1(34 eyes),33 eyes were cured(no epiphora,no suppuration,unobstructed tractus lacrimalis),1 eye was better than before,and none was of no effect. The recovery rate was 97%. In group No.2(34 eyes),29 eyes had been cured,4 eyes were better than before,and 1 eye was of no effect. The recovery rate was 88%. ·CONCLUSION:If SH is used in dacryocystorhinostomy,it can reduce errhysis,avoid anastomotic stoma adhering,keep anastomotic stoma unblocked and improve the surgery achievement ratio.