同期鼻内镜下行鼻部手术及泪囊鼻腔吻合术临床分析

摘要

Objective To analyze the efficacy of one-stage operation combined nasal surgery with dacryocystorhinostomy under nasal endoscope based on a clinical analysis. Methods Included in this work were 54 cases (58 sides) with chronic dacryocystitis accompanying with nasal structural abnormalities treated in our Hospital during the period of May, 2013 to Dec., 2015. They were all treated by one-stage operation combined nasal surgery with dacryocystorhinostomy under nasal endoscope. Then, they were followed up for 6 months postoperatively to statistically analyze the total effective rates?of?such a treating program at the 1st, 3rd and 6th months following the therapy respectively. Rusnlt By the end of 1st month following the operation, 10 sides were effective in the group of cases with deviated nasal septum, 5 sides effective in the cases with a freak curve in the middle turbinate, and 25 sides effective among them with chronic sinusitis complicated by polyps, with a total effective rate of 70.00% herein. Then, the effective sides were 13, 5 and 30, with a total effective rate of 82.76% by the end of 3rd month after the operation, and 15, 5, and 30, with a total effective rate of 94.83% for cases in these groups by the end of 6th month following the surgery respectively. However, 3 cases with chronic rhinosinusitis complicated with polyps had their dacryocystitis reoccurred following the therapeutic procedure because of recurrence of rhinosinusitis and nasal polyps. Conclusion For those cases of chronic dacryocystitis with chronic nasal diseases, one-stage surgery can be utilized to treat these conditions simultaneously, and better therapeutic effect can be achieved with good prognosis as well.%目的：分析鼻内镜下同期行鼻部手术及泪囊鼻腔吻合术的疗效及愈后。方法2013年5月年至2015年12月收治的慢性泪囊炎伴鼻部结构异常患者54例（58眼），于鼻内镜下同期行鼻部手术及泪囊鼻腔吻合术，术后随访6个月，分别统计分析术后第1、3、6月时的总有效率。结果术后第1月时，鼻中隔偏曲组有效10眼，反常曲线中鼻甲组有效5眼，慢性鼻窦炎伴息肉组有效25眼，总有效率为70.00%；术后第3月时，鼻中隔偏曲组有效13眼，反常曲线中鼻甲组有效5眼，慢性鼻窦炎伴息肉组有效30眼，总有效率为82.76%；术后6月时，鼻中隔偏曲组有效15眼，反常曲线中鼻甲组有效5眼，慢性鼻窦炎伴息肉组有效35眼，总有效率为94.83%。3例慢性鼻窦炎伴息肉患者因鼻息肉复发再次引发泪囊炎。结论鼻部疾病伴慢性泪囊炎患者同期手术治疗，疗效及愈后均好。