目的：比较自交联透明质酸钠凝胶、纳吸棉、明胶海绵在鼻内镜下泪囊鼻腔吻合术(En-DCR)中的疗效。

方法：回顾性分析2019-06/2020-06我院收治的慢性泪囊炎均行En-DCR患者72例90眼，按吻合口填充材料类型分为三组，使用自交联透明质酸钠凝胶组(A组)、纳吸棉组(B组)、明胶海绵组(C组)，术后2wk，1、2、3、6mo定期随访，观察患者术后舒适度、渗血情况、瘢痕增生、肉芽组织形成、吻合口黏连以及溢泪、泪道冲洗情况，并统计治愈率和有效率。

结果：术后随访6mo，A、B、C三组有效率为97%、89%、94%(P>0.05)； 治愈率为91%、56%、87%(P<0.05)，A、C两组与B组治愈率比较有差异(P<0.0167)，A、C两组之间无差异(P>0.0167)。A组患者术后舒适度较B组好(P<0.0167)，术后渗血情况较B组严重(P<0.0167)。A组瘢痕增生率低于B组(P<0.0167)，A、B组吻合口黏连率均高于C组(P<0.0167)。

结论：En-DCR术中应用自交联透明质酸钠凝胶填充泪囊鼻腔吻合口术中操作简单，术后可有效抑制瘢痕增生、促进黏膜上皮化，提高En-DCR的治愈率及有效率，且患者舒适度高，是一种简便、安全、舒适、高效的可吸收吻合口填充材料。

METHODS:Totally 72 patients(90 eyes)of chronic dacryocystitis admitted to our hospital from June 2019 to June 2020, and randomly divide them into three groups. Self-crosslinking sodium hyaluronic gel(group A), Nasopore(group B), and gelfoam(group C)were used during the En-DCR. Comfort level, bleeding, complication and epiphora, lacrimal situation were observed 2wk, 1, 2, 3, 6mo after surgery. Comparison of cure rate and effective rate.

RESULTS: The patients were followed up for 6mo after operation. The cure rate of lacrimal system reconstruction was 97% in group A, 89% in group B and 94% in group C. There was no meaningful statistical difference among the three groups(P>0.05). The effective rate of lacrimal system reconstruction was 91% in group A, 56% in group B and 87% in group C(P<0.05). There was significant statistical difference between groups A and B or between groups B and C(P<0.0167), however, there was no meaningful statistical difference between groups A and C(P>0.0167). Postoperative comfort level was better and bleeding was more severe in the group of A than in group B(P<0.0167). In terms of complications, there was less scar proliferation in group A than in group B(P<0.0167), the rate of synechiae in groups A and B was higher than in group C(P<0.0167).

CONCLUSION:Intraoperative application of self-crosslinking sodium hyaluronic gel to packing the anastomotic stoma makes the procedure simple and can effectively inhibit scar proliferation and conducive to the epithelialization of the anastomotic stoma, improve the cure rate of En-DCR. In addition, with more comfort. It is a simple, safe, comfortable and efficient absorbable anastomotic stoma packing material.