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[摘要]
目的:寻求更加简捷、有效的泪囊鼻腔吻合手术方式。
方法:将吻合腔不放置填塞物泪囊鼻腔吻合术167例189眼作为试验组,回顾性将以往吻合腔填塞凡士林纱条的泪囊鼻腔吻合术103例121眼作为对照组。随访6~36(平均15±3.6)mo,比较其治愈好转率、术后鼻腔出血发生率。
结果:治愈好转率:试验组:97.9%,对照组97.5%,两组间差异无统计学意义(P>0.05)。术后中重度鼻腔出血发生率:试验组:15.9%,对照组31.4%,两组间差异有统计学意义(P<0.01)。
结论:行泪囊鼻腔吻合术时,只要术中吻合腔制作得当,止血彻底,术后鼻腔引流得法,吻合腔不放置填塞物同样有效,术后中重度鼻腔出血反而减少。
[Key word]
[Abstract]
AIM: To find an efficient and simple surgical procedure of the external dacryocystorhinostomy(EXT- DCR)in the treatment of chronic dacryocystitis.
METHODS: A total of 270 cases were performed in this retrospective study. A comparison of clinical effects and hemorrhage complications between the experimental group, in which 189 eyes of 167 patients that underwent traditional EXT-DCR without packing, and the control group, in which 121 eyes of 103 patients that underwent traditional EXT-DCR with Vaseline gauze were performed. The postoperative follow-up ranged from 6 to 36mo(the mean follow-up was 15±3.6mo).
RESULTS: There were no significant differences in the curative rates between the two groups(97.9% vs 97.5%, P>0.05). But the incidence rate of moderate or severe postoperative nasal bleeding was lower in the experimental group(15.9%, 30 eyes)than the control group(31.4%, 38 eyes)and P<0.01.
CONLUSION: The traditional EXT-DCR without packingis an effective procedure and is more effective in reducing moderate or severe postoperative bleeding when the intraoperative anastomose and the postoperative drainage are well done and the intraoperative bleeding is well controlled.
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