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目的:观察一组慢性泪囊炎患者,在行泪囊鼻腔吻合术中应用明胶海绵片取代凡士林纱条作为吻合道填塞物的临床疗效。方法:采用前瞻性设对照组的方法,将83例(100只眼)慢性泪囊炎患者在其行泪囊鼻腔吻合术前随机分为①实验组(明胶海绵片填塞物组)52只眼及②对照组(凡士林纱条填塞物组)48只眼。本研究观察并比较了两种填塞物的手术成功率、术后炎性反应及吻合道出血等情况。结果:两种填塞物在以下方面均有显著性差异:实验组手术成功率为9615%,无一例手术失败者;术后无炎性反应者占8076%,仅1923%有轻度炎性反应,且无一例重度炎性反应或吻合道出血者。对照组手术成功率为7916%,手术失败者833%;术后重度炎性反应者占1666%,中度炎性反应者3750%,有4583%轻度炎性反应;吻合道出血者占75%,其中重度出血者416%,中度出血者1666%,轻度出血者5416%。结论:本研究结果提示,在行泪囊鼻腔吻合术时,采用明胶海绵片完全可以取代目前临床上广泛应用的凡士林纱条作为吻合道填塞物,不仅手术成功率高,而且术后并发症亦明显减少。
Objective: To observe a group of patients with chronic dacryocystitis in the dacryocystorhinostomy in the application of gelatin sponge strips instead of Vaseline gauze as anastomosis tamponade clinical curative effect. Methods: 83 patients (100 eyes) with chronic dacryocystitis were randomly divided into ① experimental group (gelatin sponge pad stuffing group) 52 eyes And ② control group (Vaseline gauze padding group) 48 eyes. This study observed and compared the success rate of two types of tamponade, postoperative inflammatory response and anastomotic bleeding. Results: The two kinds of tamponade were significantly different in the following aspects: The successful rate of operation was 96.15% in the experimental group, and none of the patients failed the operation; the postoperative no inflammatory reaction accounted for 80.76% and only 1923% A mild inflammatory reaction, and no case of severe inflammatory reaction or bleeding in the anastomosis. The success rate of operation was 79.16% in control group and 833% in operation failure, 1666% in severe inflammatory reaction, 3750% in moderate inflammatory reaction and 4583% in mild Inflammatory reaction; 75% of anastomosed hemorrhage, including severe bleeding in 4 16%, moderate bleeding 16 66%, mild bleeding 54 16%. Conclusions: The results of this study suggest that gelatin sponge strips can completely replace the vaseline gauze widely used in clinical practice as an anastomosis block in dacryocystorhinostomy. Not only the success rate of operation is high, but also the postoperative complications obviously decrease.