缝线吻合技术在鼻内镜下泪囊鼻腔吻合术中的应用

Application of suture anastomosis in nasal endoscopic dacryocystorhinostomy

摘要:

目的 探讨鼻内镜下泪囊鼻腔吻合术（En-DCR）中应用缝线吻合技术治疗慢性泪囊炎的效果。方法 回顾性分析该院79例（79眼）慢性泪囊炎患者的临床资料，分为缝合组和无缝合组。无缝合组给予En-DCR瓣膜单纯明胶海绵固定技术，缝合组给予En-DCR瓣膜缝线吻合技术。比较两组患者的临床总有效率、术后并发症发生率、吻合口修复时间和肉芽增生等情况。结果 术后两组患者总有效率比较，差异无统计学意义（χ² = 4.36，P = 0.137），并发症总发生率比较，差异无统计学意义（P = 0.705）。缝合组造口黏膜上皮愈合时间短于无缝合组，差异有统计学意义（t = 0.57，P = 0.032），造口肉芽增生少于无缝合组，差异有统计学意义（P = 0.037）。结论 瓣膜缝线吻合并未改善其临床有效性和安全性，但可缩短造口黏膜上皮愈合时间，减少组织肉芽增生。

Abstract:

Objective To investigate the efficacy of endoscopic dacryocystorhinostomy (En-DCR) and suture anastomosis in treatment of chronic dacryocystitis.Method Clinical data of 79 cases (79 eyes) of chronic dacryocystitis were enrolled retrospectively and divided into suture group and seamless group. In the seamless group, the En-DCR valve was fixed with simple gelatin sponge, and in the suture group, the En-DCR valve suture was used. The total clinical effective rate, postoperative complication rate, anastomotic repair time and granulation hyperplasia of the two groups were analyzed and compared.Results There was no statistically significant difference in total effective rate between the two groups after operation (χ² = 4.36, P = 0.137), there was no statistically significant difference in the incidence of complications (P = 0.705). The healing time of stoma mucosa epithelium in suture group was shorter than that in seamless group, the difference was statistically significant (t = 0.57, P = 0.032); The stoma granulation hyperplasia suture group was less than the seamless group, the difference was statistically significant (P = 0.037).Conclusion The combination of valve suture does not improve its clinical efficacy and safety, but can shorten the healing time of mucosal epithelium and reduce the granulation hyperplasia of stoma.