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目的 探讨外路泪囊鼻腔吻合术 (externaldacryocystorhinostomy ,EXT DCR)的治疗效果和手术技巧。方法 回顾性分析行EXT DCR的 95 7眼的治愈率、溢泪率、出血率。随机分术前使用止血敏组与未使用止血敏组 ,并统计其影响术中出血的差异性 ;术中内眦韧带断离否对溢泪的影响差异性。结果 本组行EXT DCR的治愈率为 97 0 7% ,成功率为 99 16 %。术中内眦韧带离断组 (9/2 3)与不断组 (11/934)溢泪率分别为 39 13%和 1 18% (P <0 0 1) ,两者差异有显著意义 ;术前使用止血敏组 (2 7/5 18)与不使用组 (5 1/439)术中出血率分别为 5 2 1%和 11 6 2 % (P <0 0 1) ,两者差异有显著意义。结论 术前使用止血敏的改良EXT DCR是简易、快速、美观、颇具疗效的首选方法 ,手术关键是预防术中的出血。
Objective To investigate the therapeutic effect and surgical technique of external dacryocystorhinostomy (EXT DCR). Methods Retrospective analysis of 957 eyes of EXT DCR cure rate, tear overflow rate, bleeding rate. Randomly divided preoperative use of hemostatic group and non-use of hemostatic group, and statistical differences in the impact of intraoperative bleeding; Intraoperative intravaginal ligament off no effect on the overflow of tears. Results The cure rate of EXT DCR in this group was 97.07% with a success rate of 99.16%. Intraoperative tears in the ligament rupture group (9/2 3) and the continuous group (11/934) were 39.13% and 18% (P <0.01), respectively, with significant differences between the two groups The intraoperative bleeding rate was 52.1% and 11.62% respectively (P <0.01) before the use of hemostatic group (27/518) and no use group (5 1/439), the difference was significant significance. Conclusion The improved EXT DCR with hemostatic sensitivity before surgery is the first choice of simple, rapid, beautiful and curative effect. The key of operation is to prevent intraoperative bleeding.