方法：将43例50眼NLDO患者随机分为SHSI组(21例25眼)和En-DCR组(22例25眼)，比较两组患者术中出血量、单眼手术时间、手术不适及住院时间，随访至术后12mo，根据末次随访时溢泪与泪道灌洗情况评估临床疗效，并采用成本-效果比(C/E)进行经济效益评估。

结果：SHSI组患者术中出血量与手术不适视觉模拟评分显著低于En-DCR组(4.96±1.989mL vs 27.60±14.950mL，2.84±0.64分 vs 4.88±0.84分)，单眼手术时间与住院时间显著短于En-DCR组(13.40±6.007min vs 59.64±12.786min，0.50±0.010h vs 137.280±23.085h)(均P<0.001)。末次随访时，两组患者临床有效率无差异(88% vs 96%，P>0.05)，但SHSI组患者C/E(13.57)远小于En-DCR(121.50)。

结论：内窥镜下SHSI与En-DCR均为NLDO的有效手术治疗方法，但SHSI手术难度相对更低且具有明显的成本效益优势。

METHODS: The 43 patients with 50 eyes of NLDO were randomly divided into SHSI group(21 cases and 25 eyes)and En-DCR group(22 cases and 25 eyes). Then to compared the intraoperative bleeding volume, monocularoperation time, surgical discomforta, nd hospitalization time between the two groups of patients. Followed-up to 12mo after surgery, the clinical efficacy was evaluated according to the situation of tear overflow and lacrimal lavage at the last follow-up, and the cost-effectiveness ratio(C/E)was used to evaluate the economic benefits.

RESULTS: The intraoperative blood loss and surgical discomfort visual analogue scores of patients in the SHSI group were significantly lower than those in the En-DCR group(4.96±1.989mL vs 27.60±14.950mL, 2.84±0.64 vs 4.88±0.84). Monocular surgery time and hospital stay were significantly shorter than those in the En-DCR group(13.40±6.007min vs 59.64±12.786min, 0.50±0.010h vs 137.280±23.085h)(All P<0.001). At the last follow-up, the clinical effectiveness rate of the two groups was no difference(88% vs 96%, P>0.05), but the C/E(13.57)of patients in SHSI group was far smaller than that of En-DCR(121.50).

CONCLUSION: Endoscopic SHSI and En-DCR are both effective surgical methods for nldo. But SHSI surgery is relatively lower difficult and has significant cost-effective advantages.