目的：探究鼻内镜下泪囊鼻腔吻合术(EES-DCR)联合RS型泪道引流管置入术及扩张支架治疗小泪囊患者慢性泪囊炎的疗效研究。

方法：回顾性分析2018-12/2023-12本院收治的298例298眼慢性泪囊炎小泪囊患者。根据治疗方式不同分为两组，对照组149例149眼患者行EES-DCR联合RS型泪道引流管置入术，观察组149例149眼在对照组基础上联合扩张支架。比较两组患者术后6 mo的疗效、术后3 mo眼部指标\〖泪液分泌量(SⅠt)、泪膜破裂时间(BUT)、溢泪程度\〗、术后3、6 mo疼痛程度的变化情况以及并发症的发生情况。

结果：术后6 mo观察组疗效更优(P<0.05)。与术前相比，术后3 mo两组患者BUT显著升高，SⅠt、溢泪程度显著降低，且观察组更优(均P<0.05)。两组各时间点VAS评分比较有差异(F_交互=181.032，P_交互<0.001； F_时间=138.215，P_时间<0.001； F_组间=41.343，P_组间<0.001)。与术前相比，两组患者术后的VAS评分均减小(观察组：t_{术后3 mo}=22.086，t_{术后6 mo}=35.192，均P<0.001； 对照组：t_{术后3 mo}=19.031，t_{术后6 mo}=36.960，均P<0.001)。术后3 mo观察组VAS评分小于对照组(t=5.124，P<0.001)。术后6 mo两组并发症比较无差异(P>0.05)。

结论：EES-DCR联合RS型泪道引流管置入术及扩张支架治疗慢性泪囊炎小泪囊患者的效果更优，有效改善患者的眼部情况，缓解疼痛。

METHODS: A total of 298 patients(298 eyes)of chronic dacryocystitis with small lacrimal sac admitted to our hospital from December 2018 to December 2023 were retrospectively analyzed. They were divided into two groups according to different treatment modalities, 149 patients(149 eyes)in the control group underwent EES-DCR combined with RS-type lacrimal drainage tube placement, and 149 patients(149 eyes)in the observation group were combined with expansion stents on the basis of the control group. The efficacy of the two groups at 6 mo postoperatively, the changes in ocular indexes \〖Schirmer I test(SⅠt), tear film break-up time(BUT), and degree of tear overflow\〗 at 3 mo postoperatively, the changes in the degree of pain at 3 and 6 mo postoperatively, and the occurrence of complications were compared.

RESULTS: The efficacy of the observation group was better at 6 mo postoperatively(P<0.05). Compared with the preoperative period, the BUT was significantly higher and the degree of SⅠt and tear overflow was significantly lower in the two groups at 3 mo postoperatively, and it was better in the observation group(both P<0.05). There were differences in visual analogue scale(VAS)scores between the two groups at each time point(F_interaction=181.032, P_interaction<0.001; F_time=138.215, P_time<0.001; F_{between groups}=41.343, P_{between groups}<0.001). Compared with the preoperative period, the postoperative VAS scores of patients in both groups were reduced(observation group: t_{3 mo postoperatively}=22.086, t_{6 mo postoperatively}=35.192, both P<0.001; control group: t_{3 mo postoperatively}=19.031, t_{6 mo postoperatively}=36.960, both P<0.001). VAS scores were smaller in the observation group than in the control group at 3 mo postoperatively(t=5.124, P<0.001). Complications were not statistically different between the two groups at 6 mo pastoperatively(P>0.05).

CONCLUSION: EES-DCR combined with RS-type lacrimal drainage tube placement in the treatment of chronic dacryocystitis in patients with small lacrimal sac has a better effect, effectively improves the patient's ocular condition and relieves pain.