| 张 超,张 懿,安艳萍,杨 华,王维荣.同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的疗效对比研究[J].,2021,(24):4778-4781 |
| 同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的疗效对比研究 |
| Comparative Study on the Efficacy of Simultaneous and Staged Endoscopic Sinus Surgery in the Treatment of Chronic Dacryocystitis Combined with Chronic Rhinosinusitis |
| 投稿时间：2021-03-29 修订日期：2021-04-25 |
| DOI：10.13241/j.cnki.pmb.2021.24.037 |
| 中文关键词: 慢性泪囊炎 慢性鼻-鼻窦炎 同期手术 分期手术 疗效 并发症 生活质量 |
| 英文关键词: Chronic dacryocystitis Chronic rhinosinusitis Simultaneous surgery Staged surgery Curative effect Complications Quality of life |
| 基金项目:陕西省科学技术研究发展计划项目（2016SF-328） |
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| 中文摘要: |
| 摘要 目的：探讨同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的临床疗效。方法：回顾性分析本院2017年1月至2019年10月期间收治的76例慢性泪囊炎合并慢性鼻-鼻窦炎患者的临床资料，根据手术方式分为A组和B组，各38例。A组行分期手术（鼻腔鼻窦病变处理控制鼻腔鼻窦炎症后再行鼻内镜下泪囊鼻腔造孔术）。B组行同期手术（处理鼻腔鼻窦病变后立即行鼻内镜下泪囊鼻腔造孔术），比较两组围术期指标、临床疗效、术后并发症发生情况，采用慢性泪囊炎生活质量量表（DQOLS）评价患者术前和术后6个月时的生活质量。结果：B组总有效率为94.74 %（36/38），A组总有效率为92.11 %（35/38），两组总有效率比较无明显差异（P>0.05）；B组术后并发症总发生率为13.16 %（5/38），与A组的10.53 %（4/38）比较无明显差异（P>0.05）。两组患者术后6个月时的DQOLS各维度评分和总分均较术前升高（P<0.05），但组间比较差异均无统计学意义（P>0.05）。B组患者住院总费用少于A组，住院时间、手术时间均短于A组（P<0.05），两组术中出血量比较无明显差异（P>0.05）。结论：同期手术与分期手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎患者具有相当的临床疗效和安全性，且对患者生活质量的改善程度亦无明显差异，但前者能够缩短手术时间、住院时间及减少住院费用。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical effect of simultaneous and staging endoscopic sinus surgery for chronic dacryocystitis combined with chronic rhinosinusitis. Methods: 76 cases of chronic dacryocystitis complicated with chronic rhinosinusitis in our hospital from January 2017 to October 2019 were selected retrospectively, and divided into group A and group B according to operation method, with 38 cases in each group. The group A underwent staged surgery(the nasal cavity and sinus lesions were treated to control the inflammation of the nasal cavity and sinus, and then underwent endoscopic dacryocystorhinostomy). The group B underwent simultaneous surgery(treatment of nasal cavity and sinus lesions immediately underwent endoscopic dacryocystorhinostomy). The perioperative indicators,clinical efficacy and postoperative complications were compared between the two groups. Chronic dacryocystitis Quality of Life Scale (DQOLS) was used to evaluate the quality of life of patients before and 6 months after surgery. Results: The total effective rate was 94.74%(36/38) in the group B, and 92.11%(35/38) in the group A, and there was no significant difference in the total effective rate between the two groups (P>0.05). The total incidence rate of postoperative complications in the group B was 13.16% (5/38), with no significant difference compared with 10.53% (4/38) in the group A(P>0.05). DQOLS scores of all dimensions and total scores of patients in both groups at 6 months after surgery were higher than those before surgery(P<0.05), but there was no statistically significant difference between the two groups(P>0.05). The operation time and hospital stay of patients in the group B were shorter than those in the group A, and the total cost of hospitalization was less than that in the group A(P<0.05). There was no significant difference in intraoperative blood loss between the two groups (P>0.05). Conclusion: Simultaneous surgery and staged surgery for patients with chronic dacryocystitis combined with chronic rhinosinusitis have considerable clinical efficacy and safety, and there is no significant difference in the improvement degree of patients' quality of life, but the former can shorten the operation time, hospital stay and reduce the cost of hospitalization. |
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