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[鼻内镜下泪囊鼻腔造口术结局的长期随访]

[Long-term follow-up for outcomes of intranasal endoscopic dacryocystorhinostomy].

作者信息

Zhou Bing, Han De-Min, Huang Qian, Cui Shun-Jiu, Tang Xin

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Jan;43(1):13-7.

Abstract

OBJECTIVE

To sum up and analyze the long-term follow-up outcomes of intranasal endoscopic dacryocystorhinostomy (IEDCR) in patients with chronic dacryocystitis. The related factors to clinical effects were discussed.

METHODS

The operative and postoperative data were collected in 275 patients (310 eyes, mean age 28.3 years; range 3 to 76 years) who were undergone IEDCR with chronic dacryocystitis. All patients conceived the preoperative dacryocystography. Surgical intervention was performed under general or local anesthesia and all were done by the same surgeon. The silicon intubation was used according to the size of lacrimal sac. The postoperative follow-up management included endoscopic cleaning, lacrimal duct irrigation and nasal corticosteroid spray.

RESULTS

The patients with follow-up period less than 1 year were excluded from this group. 211 cases (230 eyes) were followed up over 1 year and the results showed that 75.3% were cured, 11.7% improved and 13.0% had no effects. The natural lacrimal apparatus was found reopened in 9 cases while their lacrimal rhinostomies were closed with scar. There was no operative complications.

CONCLUSIONS

The long-term outcomes of IEDCR are good. The wide bony rhinostomy, less mucosal damage and closed follow-up debrided should benefit for getting a high operative success rate. After surgical drainage, the inflammation mucosa of lacrimal sac might return to normal and the function of nasolacrimal apparatus might recover.

摘要

目的

总结并分析慢性泪囊炎患者鼻内镜下泪囊鼻腔造口术(IEDCR)的长期随访结果。探讨影响临床疗效的相关因素。

方法

收集275例(310眼,平均年龄28.3岁;范围3至76岁)接受IEDCR治疗的慢性泪囊炎患者的手术及术后资料。所有患者均进行了术前泪囊造影。手术干预在全身或局部麻醉下进行,均由同一位外科医生完成。根据泪囊大小使用硅胶插管。术后随访管理包括内镜清洁、泪道冲洗和鼻腔皮质类固醇喷雾。

结果

随访时间不足1年的患者被排除在该组之外。211例(230眼)随访超过1年,结果显示75.3%治愈,11.7%好转,13.0%无效。9例发现自然泪道重新开放,但其泪囊鼻腔造口处瘢痕封闭。无手术并发症。

结论

IEDCR的长期效果良好。宽大的骨性鼻腔造口、较少的黏膜损伤和封闭的随访清创有利于获得较高的手术成功率。手术引流后,泪囊的炎性黏膜可能恢复正常,鼻泪管装置的功能可能恢复。

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