Tsirbas A, McNab A A
Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Clin Exp Ophthalmol. 2000 Feb;28(1):22-5. doi: 10.1046/j.1442-9071.2000.00249.x.
To describe the incidence, clinical features, possible risk factors and outcome of patients suffering secondary haemorrhage after dacryocystorhinostomy (DCR).
Records of all patients undergoing external DCR by one surgeon (AAM) over a 6-year period were analysed retrospectively.
After 293 DCR operations in 260 patients, 10 patients had a secondary haemorrhage (one after bilateral DCR), usually between days 4 and 10 post-operatively (mean 6.8 days). Six of the 10 were hospitalized for 2-5 days (mean 2.8 days), all of whom had nasal packing, intravenous antibiotics and intravenous fluids; none required blood transfusion. Three patients had immune system defects, three had used non-steroidal anti-inflammatory drugs (NSAID) and four had no obvious risk factors. All 10 had a successful outcome following DCR (compared to an overall failure rate of 25/293 (8.5%): 16 anatomical and nine functional).
Secondary haemorrhage after DCR was found to occur after 3.8% of DCR. Risk factors include being immunocompromised and taking NSAID prior to surgery. The haemorrhage did not adversely affect surgical outcome.
描述泪囊鼻腔吻合术（DCR）后继发性出血患者的发生率、临床特征、可能的危险因素及预后。
回顾性分析一位外科医生（AAM）在6年期间为所有患者实施外路DCR的记录。
260例患者接受了293次DCR手术，其中10例发生继发性出血（1例为双侧DCR术后），通常发生在术后4至10天（平均6.8天）。10例中有6例住院2至5天（平均2.8天），均接受了鼻腔填塞、静脉注射抗生素和静脉输液；均未输血。3例患者有免疫系统缺陷，3例使用过非甾体抗炎药（NSAID），4例无明显危险因素。10例患者DCR术后均取得成功（总体失败率为25/293（8.5%）：16例解剖失败，9例功能失败）。
发现DCR术后继发性出血的发生率为3.8%。危险因素包括免疫功能低下和术前使用NSAID。出血未对手术结果产生不利影响。
