改良鼻内窥镜下鼻腔泪囊造孔术治疗慢性泪囊炎的疗效观察

目的观察改良鼻内窥镜下鼻腔泪囊造孔术治疗慢性泪囊炎的临床治疗效果及探讨手术方式的改进。方法选择我院2008年1月～2012年6月间收治的慢性泪囊炎患者150例．根据手术方式分为实验组与对照组各75例，对照组行传统鼻腔泪囊吻合术，实验组行改良鼻内窥镜下鼻腔泪囊造孑L术，术后进行半年至两年的回访，根据患者术后炎症反应程度、临床症状改善情况等评价手术治疗效果。结果实验组治愈69例，好转6例，治疗无效者0例，治疗总有效率达100％，而对照组治愈患者58例，好转患者5例，治疗无效者12例，治疗总有效率84％，二者相比较差异明显（x2=5．14，P=0．023）；且二者在患者术后炎症反应程度上，实验组手术后炎症反应很轻，二者差异有统计学意义（P〈0．05）。结论虽然改良鼻内窥镜下鼻腔泪囊造孔术对设备和相关操作者的要求较传统鼻腔泪囊吻合术高，但经本研究证实疗效确切，术中保留了鼻腔正常黏膜，减少了术中对组织的损伤和术中出血，降低了造瘘口肉芽组织的形成，从而降低复发率，是一种简单而疗效确切的手术方式，值得临床推广应用。

Curative effect of modified dacryocystorhinostony under nasal endoscope for treatment of chronic dacryocystitis

Objective The purpose of this article is to observe the clinical effect of improved dacryocystorhinostony under nasal endoscope for treatment of chronic dacryocystitis and discuss the improvement of its surgical method. Methods A to- tal of 150 patients with dacryocystitis in our hospital from January 2008 to June 2012 were chosen and divided into test group and control group each with 75 cases according to surgical options. The control group was given conventional dacryo cystorhinostony and the test group was given improved dacryocystorhinostony under nasal endoscope （P 〈 0.05）. All patients were given a follow-up visit from half to two years after surgery. Surgical effects were evaluated according to level of post- operative inf/ammatory reaction and condition of clinical symptoms improvement （P 〈 0.05）. Results In test group, 69 pa- tients were cured, 6 were improved, 0 had no response, the total cure rate was 100%; in control group, 58 patients were cured, 8 were improved, 12 had no response, the total cure rate was84%. Compared with each other, the difference between the two groups was significant; in level of postoperative inflammatory reaction, test group was obviously slighter than control group. Conclusion Although improved dacryocystorhinostony under nasal endoscope has a higher requirement for equip- ments and handlers than conventional dacryocystorhinostony, but it has been proved by this study that it is effective and it can keep normal nasal mucosa, decrease tissue damage and hemorrhage during surgery, reduce formation of fistula granula- tion tissue. It is a simple and effective surgery option and is worthy being promoted in clinical work.