内镜下激光辅助消融造瘘伴环置套管术治疗慢性泪囊炎的初步效果评析

Evaluation of the primary effect of laser assisted ablation of leakage and annular cannula under endoscope for chronic dacryocystitis

摘要:

目的 分析内镜下泪囊鼻腔吻合术（En-DCR）中激光辅助消融造瘘伴环置套管术治疗慢性泪囊炎的初步临床疗效。方法 回顾性分析该院36例40眼慢性泪囊炎患者的临床资料，所有患者均行En-DCR及激光消融造瘘术，术中环置套管并使用5-氟尿嘧啶，于术后6周拔除套管，观察该术式的初步临床疗效。结果 术后6～12个月随访。36例40眼慢性泪囊炎中，痊愈36眼（90.0%），好转3眼（7.5%），无效1眼（2.5%），有效率为97.5%。结论 创新性利用半导体激光于En-DCR中进行消融造瘘和环置套管，并联合应用5-氟尿嘧啶，既有效减少了术中出血，又减少了造瘘口肉芽瘢痕增生，且提高了手术有效率。

关键词:鼻内镜;激光;鼻腔泪囊造瘘;慢性泪囊炎;环置套管;5-氟尿嘧啶

Abstract:

Objective To analyze the clinical efficacy of endoscopic dacryocystorhinostomy (En-DCR) in treating chronic dacryocystitis by laser-assisted ablation with annular cannula.Methods Clinical data of 36 patients with chronic dacryocystitis of 40 eyes were retrospectively analyzed. All the patients were treated with En-DCR laser ablation of leakage, during the operation, cannula and 5-fluorouracil were used. The cannula was removed 6 weeks after operation, and the initial clinical efficacy of this operation was observed.Results The patients were followed up for 6~12 months. Among the 40 eyes of 36 cases of chronic dacryocystitis, 36 eyes were cured (90.0%), 3 eyes were improved (7.5%) and 1 eye was invalid (2.5%). The effective rate was 97.5%.Conclusion The innovative use of semiconductor laser in En-DCR for ablation of leakage, annular cannula placement and combined application of 5-fluorouracil not only effectively reduced intraoperative bleeding, but also reduced the scar hyperplasia of granulation at leakage, and improved the surgical efficiency.

Key words:nasal endoscopy;laser;dacryocystorhinostomy;chronic dacryocystitis;annular casing;5-fluorouracil