河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (4): 468-471.doi: 10.3969/j.issn.1007-3205.2024.04.017

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布地奈德联合鼻内镜手术治疗慢性泪囊炎

  

  1. 1.承德医学院附属医院耳鼻喉科,河北 承德 067000;2.承德医学院附属医院眼科,河北 承德 067000

  • 出版日期:2024-04-25 发布日期:2024-04-22
  • 作者简介:齐智伟(1984-),男,河北承德人,承德医学院附属医院副主任医师,医学硕士,从事泪道疾病、鼻部疾病诊治研究。
  • 基金资助:
    河北省自然科学基金项目(H2020406019);承德市科技计划项目(202204A043) 

Budesonide combined with endoscopic surgery for chronic dacryocystitis

  1. 1.Department of Otorhinolaryngology, the Affiliated Hospital of Chengde Medical University, Hebei 
    Province, Chengde 067000, China; 2.Department of Ophthalmology, the Affiliated Hospital of 
    Chengde Medical University, Hebei Province, Chengde 067000, China

  • Online:2024-04-25 Published:2024-04-22

摘要: 目的 探讨布地奈德鼻喷雾剂联合鼻内镜手术治疗慢性泪囊炎的效果。
方法 将慢性泪囊炎患者80例(80眼)纳入前瞻性单盲研究,随机分为布地奈德组(40例)和对照组(40例)。所有患者均接受鼻内镜下鼻腔泪囊吻合术。布地奈德组应用布地奈德鼻喷雾剂喷鼻3个月,对照组应用生理性海水喷鼻3个月。比较2组手术疗效、Lund-Kenndey 评分和并发症发生情况。
结果 随访6个月时,布地奈德组疗效优于对照组(P<0.05)。术后3个月时,2组Lund-Kenndey评分低于术前,布地奈德组Lund-Kenndey评分低于对照组(P<0.05)。布地奈德组并发症发生率低于对照组(5% vs. 20%,P<0.05)。
结论 鼻内镜下鼻腔泪囊吻合术后应用布地奈德鼻喷剂治疗慢性泪囊炎安全有效,手术成功率更高、术后出现吻合口粘连、肉芽肿的概率更小,且不增加术后感染的风险。


关键词: 泪囊炎, 布地奈德, 泪囊鼻腔吻合术

Abstract: Objective To investigate the effect of budesonide combined with endoscopic surgery on chronic dacryocystitis. 
Methods In total, 80 patients (80 eyes) with chronic dacryocystitis were enrolled in a prospective single-blind study and randomly divided in to budesonide group (n=40) and control group (n=40). All patients underwent nasal endoscopic dacryocystorhinostomy. Budesonide nasal spray was used for 3 months in the budesonide group, and physiological seawater was used for 3 months in the control group. The surgical effect, Lund-Kenndey score and complications of the two groups were compared. 
Results At 6 months after follow-up, the effective rate of budesonide group was better than that of the control group (P<0.05). At 3 months after surgery, the Lund-Kenndey score in the two groups was lower than that before surgery, and lower in the budesonide group than in the control group (P<0.05). The incidence of complications in the budesonide group was lower than that in the control group (5% vs. 20%, P<0.05). 
Conclusion The application of budesonide nasal spray after nasal endoscopic dacryocystorhinostomy is safe and effective, with a higher success rate, a lower probability of anastomotic adhesion and granuloma, and does not increase the risk of postoperative infection. 


Key words: dacryocystitis, budesonide, dacryocystorhinostomy