鼻内镜下带蒂黏膜瓣转移式泪囊鼻腔造孔术治疗急性泪囊炎的临床效果及安全性观察(1)
【摘要】 目的：探討鼻内镜下带蒂黏膜瓣转移式泪囊鼻腔造孔术治疗急性泪囊炎的临床效果及安全性。方法：选取2017年2月-2018年5月本院眼科收治的急性泪囊炎患者37例(37只眼)作为研究对象，所有患者均给予鼻内镜下带蒂黏膜瓣转移式泪囊鼻腔造孔术治疗，分析其临床疗效、一次性引流管使用、术后24 h情况观察及处理，以及泪囊区皮肤瘢痕情况。结果：本研究37例(37只眼)患者在手术过程中，20例(20只眼)因泪小点狭窄、堵塞、泪囊异常使用一次性泪道引流管(泪道硅胶管)，使用率为54.05%。32例(32只眼)产生疗效，临床总有效率为86.49%；其中治愈25例(25只眼)，治愈率为67.57%；有效7例(7只眼)，有效率为18.92%；无效5例(5只眼)，无效率为13.51%。术后24 h内，鼻腔内疼痛23例(23只眼)仅给予观察处理；眼部磨涩不适18例(18只眼)仅给予观察处理；鼻孔或咽部少量渗血31例(31只眼)仅给予观察处理；2例(2只眼)鼻部滴血/咽喉咳血较多，给予鼻孔填塞。将健康眼泪囊区皮肤与患眼进行比较，其中美观满意31例(31只眼)，美观不满意6例(6只眼)，泪囊区皮肤瘢痕美观满意率为83.78%。结论：鼻内镜下带蒂黏膜瓣转移式泪囊鼻腔造孔术是治疗急性泪囊炎的理想方法，疗效肯定，患者对于泪囊区皮肤瘢痕美观满意率较高，受到患者的青睐，建议在临床上推广应用。
【关键词】 鼻内镜； 带蒂黏膜瓣； 鼻腔造孔术； 急性泪囊炎； 安全性
【Abstract】 Objective：To investigate the clinical effect and safety of nasal endoscopic pedicled mucosal flap transfer of dacryocystorhinostomy in the treatment of acute dacryocystitis.Method：A total of 37 patients (37 eyes) with acute dacryocystitis admitted in ophthalmology department of our hospital from February 2017 to May 2018 were selected as the study objects.All patients were treated with nasal endoscopic pedicled mucosal flap transfer of dacryocystorhinostomy.The clinical efficacy，use of disposable drainage tube，observation and treatment of 24 hours after operation and skin scarring in the lacrimal sac area were analyzed.Result：A total of 37 patients (37 eyes) in this study，20 cases (20 eyes) were treated with disposable lacrimal duct drainage tube (lacrimal duct silicone tube) because of lacrimal puncta stenosis，occlusion and lacrimal sac abnormality during operation，the utilization rate was 54.05%.32 cases (32 eyes) had curative effect，the total clinical effective rate was 86.49%.Among them，25 cases (25 eyes) were cured， the cure rate was 67.57%；7 cases (7 eyes) were effective，the effective rate was 18.92%；5 cases (5 eyes) were ineffective，the ineffective rate was 13.51%.Within 24 h after operation，23 cases (23 eyes) of nasal pain were treated only by observation；18 cases (18 eyes) of ocular astringency were treated only by observation；31 cases (31 eyes) of nasal or pharyngeal bleeding were treated only by observation；2 cases (2 eyes) of nasal bleeding/throat hemoptysis were more and nasal stuffing was given.The skin of healthy eyes in the lacrimal sac area was compared with that of affected eyes.Among them，31 cases (31 eyes) were aesthetically satisfactory，6 cases (6 eyes) were aesthetically unsatisfactory，and the aesthetically satisfactory rate of skin scar in the lacrimal sac area was 83.78%.Conclusion：Nasal endoscopic pedicled mucosal flap transfer type of dacryocystorhinostomy is an ideal method in the treatment of acute dacryocystitis.The curative effect is certain. The patients have a higher satisfaction rate for skin scars in the lacrimal sac area，which is favored by patients.It is suggested that it be popularized and applied in clinic., http://www.100md.com(黄碧文 劳国光 姚卫兰)
【关键词】 鼻内镜； 带蒂黏膜瓣； 鼻腔造孔术； 急性泪囊炎； 安全性
【Abstract】 Objective：To investigate the clinical effect and safety of nasal endoscopic pedicled mucosal flap transfer of dacryocystorhinostomy in the treatment of acute dacryocystitis.Method：A total of 37 patients (37 eyes) with acute dacryocystitis admitted in ophthalmology department of our hospital from February 2017 to May 2018 were selected as the study objects.All patients were treated with nasal endoscopic pedicled mucosal flap transfer of dacryocystorhinostomy.The clinical efficacy，use of disposable drainage tube，observation and treatment of 24 hours after operation and skin scarring in the lacrimal sac area were analyzed.Result：A total of 37 patients (37 eyes) in this study，20 cases (20 eyes) were treated with disposable lacrimal duct drainage tube (lacrimal duct silicone tube) because of lacrimal puncta stenosis，occlusion and lacrimal sac abnormality during operation，the utilization rate was 54.05%.32 cases (32 eyes) had curative effect，the total clinical effective rate was 86.49%.Among them，25 cases (25 eyes) were cured， the cure rate was 67.57%；7 cases (7 eyes) were effective，the effective rate was 18.92%；5 cases (5 eyes) were ineffective，the ineffective rate was 13.51%.Within 24 h after operation，23 cases (23 eyes) of nasal pain were treated only by observation；18 cases (18 eyes) of ocular astringency were treated only by observation；31 cases (31 eyes) of nasal or pharyngeal bleeding were treated only by observation；2 cases (2 eyes) of nasal bleeding/throat hemoptysis were more and nasal stuffing was given.The skin of healthy eyes in the lacrimal sac area was compared with that of affected eyes.Among them，31 cases (31 eyes) were aesthetically satisfactory，6 cases (6 eyes) were aesthetically unsatisfactory，and the aesthetically satisfactory rate of skin scar in the lacrimal sac area was 83.78%.Conclusion：Nasal endoscopic pedicled mucosal flap transfer type of dacryocystorhinostomy is an ideal method in the treatment of acute dacryocystitis.The curative effect is certain. The patients have a higher satisfaction rate for skin scars in the lacrimal sac area，which is favored by patients.It is suggested that it be popularized and applied in clinic., http://www.100md.com(黄碧文 劳国光 姚卫兰)
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