眼科 ›› 2025, Vol. 34 ›› Issue (5): 377-383.doi: 10.13281/j.cnki.issn.1004-4469.2025.05.008

• 论著 • 上一篇    下一篇

鼻内窥镜下泪囊鼻腔造孔联合置入全降解鼻窦药物支架治疗慢性泪囊炎的1年疗效观察

郑群1   张一2     

  1. 1南京爱尔眼科医院,南京210001;2锦州爱尔眼科医院,辽宁锦州121000
  • 收稿日期:2025-04-16 出版日期:2025-09-25 发布日期:2025-09-12
  • 通讯作者: 郑群,Email:279104954@qq.com

One year efficacy observation of fully degradable sinus drug stents in endoscopic dacryocystorhinostomy for chronic dacryocystitis

Zheng Qun1, Zhang Yi2   

  1. 1 Nanjing Aier Eye Hospital, Nanjing 210001, China; 2 Jinzhou Aier Eye Hospital, Jinzhou Liaoning 121000, China
  • Received:2025-04-16 Online:2025-09-25 Published:2025-09-12
  • Contact: Zheng Qun, Email: 279104954@qq.com

摘要:  目的 研究经鼻内窥镜下泪囊鼻腔造孔手术中置入全降解鼻窦药物支架治疗慢性泪囊炎的疗效。设计  回顾性病例系列。研究对象  2021年2月至2024年2月南京爱尔眼科医院慢性泪囊炎鼻内窥镜下泪囊鼻腔造孔手术患者286例(286眼)。方法  回顾患者的病历资料。单纯泪囊鼻腔造孔组94例(94眼),泪囊鼻腔造孔联合RS管置入组95例(95眼),泪囊鼻腔造孔联合全降解鼻窦药物支架(规格25 mm×14 mm,输送系统装置器角度为70°)置入组97例(97眼)。术后随访1年。治疗有效的标准为泪道冲洗通畅,无溢泪或溢泪减轻。主要指标  有效率、术后内镜下处理次数。结果  术后随访1年,单纯泪囊鼻腔造孔组、泪囊鼻腔造孔联合RS管置入组、泪囊鼻腔造孔联合全降解鼻窦药物支架置入组有效率分别为92.6%、94.7%、100%(治愈率 97.9%)(P=0.013)。术后1年内内镜处理次数分别为(1.54±0.60)、(2.08±0.54)、(0.13±0.37)次(P=0.000)。结论  经鼻内窥镜下泪囊鼻腔造孔术治疗慢性泪囊炎时,与单纯泪囊鼻腔造孔以及泪囊鼻腔造孔联合RS管置入比,联合全降解鼻窦药物支架更具优势,值得临床应用推广。 

关键词: 慢性泪囊炎, 泪囊鼻腔造孔术, 鼻内镜, 鼻窦药物支架

Abstract:  Objective To explore the clinical efficacy of utilizing fully biodegradable sinus drug scaffolds in endoscopic dacryocystorhinostomy for the treatment of chronic dacryocystitis. Design Retrospective case series. Participants From February 2021 to February 2024, 286 patients (286 eyes) underwent endoscopic dacryocys torhinostomy for chronic dacryocystitis in Nanjing Aier Eye Hospital. Method  The patient's medical records were reviewed. 286 patients were divided into three groups: 94 cases with simple dacryocystorhinostomy, 95 cases with dacryocystorhinostomy combined with RS tube insertion, and 97 cases with fully degradable sinus drug stent used as stent support between the lacrimal sac and nasal mucosa during surgery (with a specification of 25 mm×14 mm and 70 degrees). A one-year postoperative follow-up was conducted. The criteria for effective treatment are unobstructed irrigation of the lacrimal passage, no or reduced overflow of tears. Main Outcome Measures The effectiveness rate and the number of endoscopic interventions post-surgery. Results Following a one-year postoperative follow-up, the cure rate for cases utilizing fully degradable sinus drug stents intraoperatively was 97.9%, with an overall effectiveness rate of 100%. The effectiveness rate for simple dacryocystorhinostomy stood at 92.6%, whereas for dacryocystorhinostomy combined with RS tube insertion, it was 94.7%. The statistical difference in effectiveness rates among the three groups was significant (P=0.013). The number of endoscopic interventions within one year after surgery were (1.54±0.60), (2.08±0.54), and (0.13±0.37) times, respectively (P=0.000). Conclusion The combination of endoscopic dacryocystorhinostomy and fully degradable sinus drug stent has significant clinical advantages than simple dacryocystorhinostomy and dacryocystorhinostomy combined with RS tube insertion in the treatment of chronic dacryocystitis and is worthy of clinical application and promotion.

Key words: Chronic dacryocystitis, Endoscopic nasal dacryocystostomy, Nasal endoscopy, Sinus drug-eluting stent