鼻腔粘膜瓣在经鼻内镜鼻腔泪囊吻合术中的应用

摘要

目的：比较鼻内镜下鼻腔泪囊吻合术中两种不同鼻腔粘膜瓣的处理方法的疗效。方法将61例(61眼)慢性泪囊炎患者，根据半随机法分为A、B 2组，术中2组分别采用不同鼻腔黏膜瓣的处理方法，A组：将泪囊粘膜瓣与鼻腔粘膜瓣以银夹对夹；B组：将鼻腔粘膜瓣自前向后切开，形成“Y”形粘膜瓣，覆盖裸露骨创面。随访1年以上，比较其疗效差异。结果 A组治愈82.7%，好转7.0%，无效10.3%，总有效率89.7%；B组治愈96.4%，好转0.0%，无效.3.7%，总有效率96.4%。2组间差异有统计学意义（P<0.05）。结论鼻内镜下行鼻腔泪囊吻合术时，鼻腔横“Y”形粘膜瓣能有效覆盖裸露骨创面，防止吻合口狭窄及闭锁，提高吻口开放率，值得临床推广应用。%Objective To compare the effects of two different methods of dealing with the nasal mucosal falp in nosal endoscopic dacryocystorhinostomy. Methods 61 patients(61 eyes) with chronic dacryocystitis were divided into A and B groups with semi-random Method. After opening the lacrimal sac,A group: the lacrimal sac mucosa flap and nasal mucosa flap with silver clip to clip; group B:nasal mucosal flap from anterior to posterior incision,forming“Y”shape mucosal flap,covered the exposed bone wound. Follow-up more than one year to compare the curative effects. Results In group A, 24 cases (24 eyes,82.74%) were cured,2 cases (2 eyes,7.0%) were inproved,3 cases(3 eyes 10.3%) were ineffective,the total effective rate was 89.7%.In group B, 27 cases (27 eyes,96.4%) were cured,0 cases (0 eyes,0.0%) were inproved,1 cases(1 eyes 3.6%) were ineffective,the total effective rate was 96.4%.With a significant difference between them(P<0.05). Conclusion Nosal endoscopic Dacryocystorhinostomy ueing type“Y”nasal mucosal flap is effect for chronic dacryocystitis,it effectively cover the exposed bone wound to prevent anastomotic stricture and atresia,improve the anastomotic opening rete. It is worthy of clinical application.