摘要
目的探讨不同吻合口填充材料在鼻内镜下泪囊鼻腔吻合术患者中的应用效果。方法选取2023年12月至2024年12月医院收治的150例行鼻内镜下泪囊鼻腔吻合术治疗的慢性泪囊炎患者,按照随机数字表法分为三组,每组50例。A组吻合口使用自交联透明质酸钠凝胶填充;B组使用泪囊鼻腔引流支架填充;C组不填充,使用缝线缝合泪囊瓣和鼻黏膜瓣。三组术后均随访3个月。比较三组手术指标、住院指标、治疗效果,以及术后3个月内并发症发生率与再入院治疗情况。结果三组术中出血量、住院时长比较,差异无统计学意义(P>0.05);C组手术时长长于A、B组(P<0.05);术后24 h时,A组VAS评分低于B、C组,且B组低于C组(P<0.05);C组治疗费用低于A、B组,且B组低于A组(P<0.05);术后3个月,三组治疗总有效率、并发症发生率比较,差异无统计学意义(P>0.05)。A、C组再入院治疗率比较,差异无统计学意义(P>0.05)。结论三种治疗方案在鼻内镜下泪囊鼻腔吻合术中均可取得良好效果。使用泪囊鼻腔引流支架填充术后需再次入院取出支架,较烦琐;自交联透明质酸钠凝胶填充费用相对较高,但可提升患者舒适度;直接缝合泪囊瓣和鼻黏膜瓣费用较低,但术后舒适度也相对较低。临床应根据患者实际情况选择吻合口填充材料。
Objective To explore the application effect of different anastomotic filling materials in patients undergoing endoscopic dacryocystorhinostomy.Methods 150 patients with chronic dacryocystitis who were admitted to our hospital and treated with endoscopic dacryocystorhinostomy from December 2023 to December 2024 were selected and randomly divided into three groups using a random number table method,with 50 cases in each group.Self-crosslinking sodium hyaluronate gel was used for anastomotic ostium filling in Group A;dacryocystorhinostomy drainage stents were used for anastomotic ostium filling in Group B;no filling material was used in Group C,whereas the lacrimal sac flaps and nasal mucosal flaps were sutured with sutures.All three groups were followed up for 3 months postoperatively.Surgical indicators,hospitalization indicators,treatment outcomes,incidence of complications within 3 months after surgery,and readmission treatment status were compared among the three groups.Results There were no significant differences in intraoperative blood loss and length of hospital stay among the three groups(P>0.05).The operation time in Group C was longer than that in Group A and Group B(P<0.05).At 24 hours after surgery,the VAS score in Group A was lower than that in Group B and Group C,and Group B was lower than Group C(P<0.05).The treatment cost in Group C was lower than that in Groups A and Group B,and Group B was lower than Group A(P<0.05).At 3 months after operation,there were no statistically significant differences in the total effective rate and the incidence of complications among the three groups(P>0.05).There was no statistically significant difference in the readmission treatment rate between Group A and Group C(P>0.05).Conclusions All three treatment plans can achieve favorable outcomes in endoscopic dacryocystorhinostomy.Anastomotic ostium filling with dacryocystorhinostomy drainage stents requires readmission for stent removal,which is relatively cumbersome.Filling with self-crosslinking sodium hyaluronate gel incurs a relatively higher cost but can improve patients'comfort level.Direct suturing of the lacrimal sac flaps and nasal mucosal flaps is associated with lower costs yet relatively poorer postoperative comfort.Clinically,an appropriate anastomotic ostium filling material should be selected based on the actual conditions of patients.
作者
陈正勇
周成银
郑扬菁
Chen Zhengyong;Zhou Chengyin;Zheng Yangjing(Fuzhou Southeast Ophthalmic Hospital(Jinshan New Hospital),Fuzhou Fujian 350002,China)
出处
《医疗装备》
2026年第2期1-4,8,共5页
Medical Equipment
关键词
慢性泪囊炎
鼻内镜下泪囊鼻腔吻合术
自交联透明质酸钠凝胶
泪囊鼻腔引流支架
双瓣缝合
Chronic dacryocystitis
Endoscopic dacryocystorhinostomy
Self-crosslinking sodium hyaluronate gel
Dacryocystorhinostomy drainage stents
Bivalve suture
