| Objective:The purpose of this study is to evaluate the clinical effect of endonasal endoscopic dacryocystorhinostomy(EES-DCR)combined with lacrimal duct expanding stent implantation or MeroGel for chronic dacryocystitis.Methods:In this study,121 patients(144 eyes)diagnosed with chronic dacryocystitis at the ophthalmology center of the Second Hospital of Jilin University from March 2018 to August 2019 were enrolled.All patients received routine ophthalmic examination,irrigation of lacrimal passage and computed tomographic dacryocystography after admission.According to different treatment methods,these patients were divided into group A(lacrimal duct expanding stent implantation group)and group B(MeroGel group).In group A,there were 59 cases(68 eyes),including 9 males(9 eyes),50 females(59 eyes),24 cases in the left eye,26 cases in the right eye,and 9 cases in both eyes,with an average age of(57.37±11.23)years old and an average course of disease(5.31±7.73)years.In group B,there were 62 cases(76 eyes),including 12 males(13 eyes),50 females(63 eyes),17 cases in the left eye,31 cases in the right eye,and 14 cases in both eyes,with an average age of(54.06±11.60)years old and an average course of disease(5.94±6.60)years.The two groups were followed up regularly after surgery.The gender,age,eye type,course of disease,previous treatment history and operation time of the two groups were recorded.The results of symptom improvement,lacrimal duct flushing and the ostium opening under nasal endoscope were used as the criteria to evaluate the efficacy,and the efficacy at 2 and 5 months after surgery was compared between the two groups.Results:There was no significant difference in gender,age,eye type,course of disease and previous treatment history between the two groups(P >0.05).Two months after surgery: 62 eyes were cured,5 eyes were improved and 1 eye was invalid in group A,with a cure rate of 91.18% and an effective rate of 98.53%.In group B,63 eyes were cured,10 eyes were improved,and 3 eyes were invalid,with a cure rate of 82.89% and an effective rate of 96.05%.There was no statistically significant difference in the effective rate and the cure rate between the two groups(P > 0.05).Five months after surgery: group A cured 58 eyes,improved 7 eyes,invalid 3 eyes,the cure rate was 85.29%,the effective rate was 95.59%.In group B,54 eyes were cured,16 eyes were improved,and 6 eyes were invalid,with a cure rate of 71.05% and an effective rate of 92.11%.The difference in the effective rate between the two groups was not statistically significant(P > 0.05),but the difference in the cure rate was statistically significant(P < 0.05).There was no significant difference in the effective rate and the cure rate for the group A between 2 months after surgery and 5 months after surgery(P >0.05).And there was also no significant difference in the effective rate and the cure rate between group B at 2 months and 5 months after surgery(P >0.05).However,the difference of operation time between the two groups was statistically significant(P < 0.05).Conclusion:Endonasal endoscopic dacryocystorhinostomy(EES-DCR)combined with lacrimal duct expanding stent implantation or MeroGel in the treatment of chronic dacryocystitis were effective,but according to the comparison of the cure rates between the two groups,it was found that the application of lacrimal duct expanding stent can improve the long-term cure rate of chronic dacryocystitis,and can shorten the operation time,reduce the frequency of postoperative review,it is worth promoting in clinical practice. |
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