经内镜两种手术方式治疗慢性泪囊炎的疗效分析

Analysis of curative effect of two surgical methods under endoscope in the treatment of chronic dacryocystitis

摘要:

目的 探讨鼻内镜下泪囊鼻腔造口术及行联合泪道置管术的临床疗效。方法 回顾性分析2015年1月－2019年11月该院确诊为慢性泪囊炎的患者52例56眼，剔除有外伤史和复发的患者。将患者分为单纯造口组（30眼）和联合泪道置管组（26眼）。联合泪道置管组采用鼻内镜下泪囊鼻腔造口术后经上下泪小点泪道置入U型硅胶管。比较两组治疗效果，采用视觉模拟评分法（VAS）评估患者术后满意度（伤口疼痛和眼部不适程度）。结果 术后随访6～12个月，单纯造口组总有效率90.0%，联合泪道置管组总有效率92.3%，两组比较，差异无统计学意义（P > 0.05）。两组患者术后满意度比较，差异有统计学意义（P < 0.01）。结论 鼻内镜下泪囊鼻腔造口联合泪道置管术治疗慢性泪囊炎，术后可致患者伤口明显疼痛和眼部不适，且增加治疗费用。单纯行鼻内镜下泪囊鼻腔造口术已能达到满意的临床疗效，患者满意度高，操作更简单、省时、经济。

Abstract:

Objective To analyze the clinical effect of dacryocystitis under nasal endoscope and combined lacrimal passage catheterization in patients with chronic dacryocystitis.Methods A retrospective analysis was made of 52 patients (56 eyes) with chronic dacryocystitis from Jan 2015 to Nov 2019, divided into simple orifice group (30 eyes) and combined lacrimal passage catheterization group (26 eyes). U silicone tube was inserted into lacrimal duct through lacrimal passage in lacrimal canaliculostomy group. The therapeutic effect and patient satisfaction [degree of pain and eye discomfort in wound pain, visual analogue scale (VAS) was used] were compared between the two groups.Results All the patients were followed up for 6~12 months. The total effective rate was 90.0% in the ovariectomy group and combined with lacrimal passage. The total effective rate was 92.3% in the catheterization group, and there was no significant difference in postoperative patient satisfaction. There was significant difference in VAS score between the two groups (P < 0.01).Conclusion The patients have obvious wound pain and eye discomfort, and increase the cost of treatment afte dacryocystorhinostomy combined with lacrimal passage catheterization is used to treat chronic dacryocystitis under nasal endoscope. Dacryocystorhinostomy under nasal endoscope has achieved satisfactory clinical effect, and the patients' satisfaction is higher, simpler, time-saving and economical.