目的：分析单纯吻合前瓣的改良式泪囊鼻腔吻合术治疗慢性泪囊炎的疗效及安全性。

方法：回顾性收集2016-03/2018-07行泪囊鼻腔吻合术的99例113眼慢性泪囊炎患者，按手术方式分为传统组(传统泪囊鼻腔吻合术，46例52眼)与改良组(单纯吻合前瓣的改良术式，53例61眼)，比较两组手术效果、术后不同时间吻合口周围肉芽组织形成率、鼻腔黏膜上皮化率、吻合口大小、手术并发症发生情况及随访1a复发率。

结果：改良组随访6mo疗效优于传统组(P<0.05)，总治愈率高于传统组(75.0% vs 95.1%，P=0.002)。术后1、3、6mo改良组肉芽组织形成率(3.8%、5.7%、9.4%)均低于传统组(P<0.001)； 术后1mo改良组鼻黏膜上皮化率高于传统组(64.2% vs 39.1%，P<0.001)； 术后6mo改良组吻合口面积大于传统组(25.63±4.76 vs 11.34±3.52mm²，P<0.01)； 改良组术后出血及总并发症发生率及随访1a复发率均低于传统组(P<0.05)。

结论：单纯吻合前瓣的改良式泪囊鼻腔吻合术治疗慢性泪囊炎手术治愈率高于传统术式，可促进鼻腔黏膜上皮化，维持吻合口宽敞，防止周围肉芽组织形成，安全有效，并发症少，复发率低。

METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.

RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% vs 95.1%)during 6mo of follow-up(P<0.05). The total cure rate was higher than that of the traditional group(P<0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% vs 39.1%, P<0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 vs 11.34±3.52mm², P<0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 vs 11.34±3.52mm²,P<0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(P<0.05).

CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.