鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床研究.docVIP

精品论文 参考文献 鼻内镜下泪囊鼻腔造孔术治疗慢性泪囊炎的临床研究 西安交通大学第二附属医院 710004 【摘 要】目的 探讨鼻内镜下泪囊鼻腔造孔术（DCR）治疗慢性泪囊炎的手术方法及应用价值。方法 收集2010年9月~2013年9月在我院确诊为慢性泪囊炎的患者的病历资料，回顾性分析鼻内镜下DCR治疗慢性泪囊炎的疗效。结果 共收集鼻内镜下DCR治疗并术中采用膨胀海绵对造孔进行扩张的慢性泪囊炎患者20例，其中伴慢性鼻窦炎2例，鼻中隔偏曲3例，外伤后并发泪囊炎1例，DCR后失败再手术1例。术后随访时间6个月~3年，治愈率为95%（19/20），好转1例，随访期间未见复发病例。结论 鼻内镜下DCR联合术中采用膨胀海绵对造孔进行扩张治疗慢性泪囊炎是一种安全、有效与微创的治疗方法。 【关键词】泪囊炎；鼻内镜；泪囊鼻腔造孔术；膨胀海绵 【Abstract】 Objective：To investigate the operative method and value of endoscopic transnasal dacryocystorhinostomy in the treatment of chronic dacryocystitis.Methods：Clinical data of patients with chronic dacryocystitis at our hospital from September 2010 to September 2013 were collected，and the clinical efficacy of endoscopic transnasal dacryocystorhinostomy in the treatment of chronic dacryocystitis was retrospectively analyzed.Results：A total of 20 patients with chronic dacryocystitis undergoing endoscopic transnasal dacryocystorhinostomy combined with intraoperative application of expansion foam to expand the stoma，among which，there were 2 patients with chronic sinusitis and 3 patients with nasal septum deviation，1 post-traumatic patient was complicated by dacryocystitis and 1 operative failure patient accepted dacryocystorhinostomy again.The postoperative follow-up time was 6 months to 3 years，the curative rate was 95%（19/20），1 patient improved，recurrent patient was not observed during the follow-up.Conclusion：Endoscopic transnasal dacryocystorhinostomy combined with intraoperative application of expansion foam to expand the stoma was a safe，effective and minimally invasive method in the treatment of chronic dacryocystitis. 【Key words】Dacryocystitis；Nasal endoscopy；Dacryocystorhinostomy；Expansion foam 慢性泪囊炎是临床常见的眼科疾病，意大利医生Toti于1904年首次采用鼻外径路行泪囊鼻腔吻合术后，临床医师常常采用此术式治疗慢性泪囊炎患者［1］。但此术式存在操作复杂、出血多、耗时长与术后面部瘢痕形成等等诸多不足［2］。1989年国外首先报道经鼻内窥镜下行DCR（dacryocystorhinostomy），［3］。近期国内孙丹洋研究发现鼻内镜下DCR治疗慢性泪囊炎操作简单、出血少、疗效好与并发症少。 随着鼻内窥镜的发展与广泛应用，鼻外径路行DCR的一些不足逐渐被鼻内镜下DCR所克服，但鼻内镜下DCR治疗后泪囊鼻腔造孔粘连、闭锁一