鼻内镜下泪囊鼻腔造口术的疗效分析

目的观察鼻内镜下泪囊鼻腔造口术治疗慢性泪囊炎的效果,探讨影响手术疗效的相关因素。方法对35例(38眼)慢性泪囊炎患者行鼻内镜下泪囊鼻腔造口术,所有患者术中制作、保留鼻腔泪囊黏膜瓣,不放置扩张管。术后应用激素喷鼻;门诊随访时,在内镜下进行清创及泪道冲洗。结果术后13～48个月,平均(29.2±9.6)个月,随访到32例(35眼),失访3例(3眼),手术有效率为91.4%(32/35)。所有手术均无并发症。结论鼻内镜下泪囊鼻腔造口术疗效满意。术中充分暴露泪囊、保留黏膜瓣是保证手术成功的关键;定期随访清创可促进黏膜健康愈合;及时发现并处理严重的瘢痕挛缩,可提高疗效。(中国眼耳鼻喉科杂志,2011,11:298-300)

Therapeutic effect of intranasal endoscopic dacryocystorhinostomy

Objective To explore the therapeutic effect of endoscopic dacryocystorhinostomy on chronic dacryocystitis and the related influencing factors. Methods The operative and postoperative data were collected in 35 chronic dacryocystitis patients （38 eyes） who had undergone endoscopic dacryocystorhinostomy. During the surgery, the mueosal flaps were preserved and no silicon intubation was adopted. The postoperative follow-up management included nasal corticosteroid spray,endoscopic debrider and lacrimal duct irrigation. Results Thirty two cases （35 eyes）were followed up for 13 to 48 months with （29.2 ± 9.6）months in average and 3 cases were out of control. The success rate was 91.4% （32/35）. No complication was found in the procedure. Conclusions The therapeutic effect of daeryocystorhinostomy on chronic dacryocystitis was good. The key factors contributing to the successful intervention included complete exposure of the sac and preservation of mucosal flap technique. Closed follow-up, debrider and prompt dealing with stenosis might benefit for getting a higher operative success rate.