方法：将我院2018-01/2021-02诊断为慢性泪囊炎合并慢性鼻窦炎，并经鼻内镜同期行鼻窦开放术和鼻腔泪囊吻合术患者共96例96眼纳入前瞻性单盲研究，术前对患者行鼻内镜检查并录像行DIP内镜评分。术后随访6mo，疗效以末次随访结果为准。根据DIP评分和术后疗效绘制受试者工作特征曲线(ROC曲线)，评价DIP内镜评分对经内镜鼻窦开放合并鼻腔泪囊吻合同期手术预后的预测价值。根据ROC曲线分析得出的最佳截断值对患者进行亚组分析，比较两组患者的年龄和性别构成比。

结果：慢性泪囊炎合并慢性鼻窦炎患者96眼中，86眼(90%)治愈，4眼(4%)好转，6眼(6%)患者无效。ROC曲线分析显示，DIP内镜评分预测经鼻内镜下鼻窦开放合并鼻腔泪囊吻合同期手术疗效的ROC曲线下面积(AUC)为0.905，约登指数最大时以DIP内镜评分16.5分为最佳临界值，此时敏感度为80.0%，特异性为86.0%。亚组分析中，两组患者年龄、性别构成比均无差异(P>0.05)； DIP评分<16.5分的患者手术疗效优于DIP评分≥16.5分的患者(P<0.05)。

结论：DIP内镜评分对经鼻内镜下鼻窦开放合并鼻腔泪囊吻合同期手术预后有较好的预测价值。

METHODS: From January 2018 to February 2021, 96 patients(96 eyes)with chronic dacryocystitis complicated with sinusitis who underwent nasal endoscopic sinus surgery and dacryocystorhinostomy were enrolled in a prospective single-blind study. Patients were examined by nasal endoscopy and recorded video to get DIP endoscopic score before operation. The patients were followed-up for 6mo, and the curative effect was based on the results of the last follow-up. The receiver operating characteristic curve(ROC curve)was drawn according to DIP endoscopic scoring system and postoperative curative effect, and the value of DIP endoscopic scoring system in predicting the prognosis of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was evaluated. According to the best cutoff value obtained by ROC curve analysis, patients were analyzed in subgroups, and the age and sex constituent ratio of two groups were compared.

RESULTS: Among the 96 eyes with chronic dacryocystitis complicated with sinusitis, 86 eyes(90%)were cured, 4 eyes(4%)were improved, and 6 eyes(6%)were invalid. ROC curve analysis showed that the area under the ROC curve(AUC)of DIP endoscopic score for predicting the curative effect of nasal endoscopic sinus surgery combined with dacryocystorhinostomy was 0.905. When Yoden index reached its peak, the DIP endoscopy score was 16.5 as the best cutoff value. At the same time, the sensitivity was 80.0% and the specificity was 86.0%. In the subgroup analysis, there was no significant difference in age and sex constituent ratio between the two groups(P>0.05); The surgical efficiency of patients with DIP endoscopic score <16.5 was better than the patients with DIP endoscopic score ≥16.5(P<0.05).

CONCLUSION: DIP endoscopic scoring system has a good predictive value for the prognosis of endoscopic of transnasal endoscopic sinus opening combined with dacryocystorhinostomy.