Analysis of the influence of postoperative personal care on the surgical outcomes of endoscopic dacryocystorhinostomy

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Methods: This prospective study evaluated the early prognosis (1 month) and personal care of 90 patients with 94 eyes who underwent endoscopic dacryocystorhinostomy (En-DCR) for Chronic dacryocystitis（CD）. Surgical outcomes were divided into ostium grade and operative effect. Operative effect was judged by subjective symptom improvement, in addition to ostium assessment based on the results of nasal endoscopic review, and the relationship between operative effect and ostium grade was explored. In addition, we analyzed the key factors affecting operative effect and ostium grade during postoperative personal care. Results: The results of correlation analysis between operative effect and objective indicators showed that the outcomes of lacrimal duct irrigation（r=0.444，P＜0.001）, DDT（r=0.217，P=0.036）, and ostium grade（r=0.350，P＜0.001） were positively correlated with the operative effect of patients. The analysis of influencing factors during postoperative nursing showed that patients with nasal saline rinsing at least once a day after operation, nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day after operation and without postoperative respiratory tract infection had better ostium grades and operative effect (P<0.05). Conclusions: The early surgical outcome of endoscopic dacryocystorhinostomy (En-DCR) is closely related to the condition of the ostium. During postoperative personal care, patients who maintain nasal saline rinsing and nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day and reasonably prevent respiratory tract infection tend to have better recovery of early postoperative ostium and better operative effect. Medical staff should strengthen the home nursing guidance for patients after En-DCR day surgery. Endoscopic dacryocystorhinostomy Chronic dacryocystitis Postoperative personal care Figures Figure 1 1 Introduction Chronic dacryocystitis (CD), mainly caused by primary acquired nasolacrimal duct obstruction (PANDO), is a common ocular inflammatory disease and ocular and nasal related diseases in ophthalmology. It is often manifested by ocular epiphora, pus discharge, skin redness and pain in the lacrimal sac area. [ 1 ],[ 2 ] Currently, the pathogenesis of PANDO remains unclear, and patients typically seek medical attention only when their condition is severe, necessitating surgical treatment. [ 3 ],[ 4 ] Dacryocystorhinostomy is currently a surgical method for CD, which mainly includes transdermal dacryocystorhinostomy(Ex-DCR)and nasal endoscopic dacryocystorhinostomy༈En-DCR༉. [ 5 ],[ 6 ] Currently, the success rate of En-DCR can be close to or even exceed that of traditional Ex-DCR . [ 7 ] Due to the advantages of minimal surgical trauma, reduced bleeding and absence of facial scarring, En-DCR was gradually preferred by patients. [ 8 ] Day surgery is a rapidly developing medical service mode. Ophthalmology is more suitable for day surgery due to its characteristics of disease diagnosis and treatment. [ 9 ] In addition to the success of the operation itself, personal home care of patients is also a very important part of postoperative rehabilitation. [ 10 ] It has been reported that the ostium will shrink significantly within 4 weeks after operation, [ 11 ] and postoperative ostium stenosis is one of the important reasons affecting the surgical efficacy of En-DCR, and nasal endoscopy should be performed regularly. [ 12 ] At present, guidelines and expert consensus have clarified the necessity of nasal endoscopic reexamination after En-DCR, [ 13 ] but it is not clear whether objective indicators are related to the subjective surgical effect of patients. After clinical investigation, in addition to regular nasal saline rinsing and medication, some patients have other nursing problems that may affect the condition of nasal cavity after surgery, such as blowing nose, taking health care products(Ginseng, Cordyceps sinensis, etc.), postoperative respiratory tract infection and so on, which may affect the recovery of postoperative ostium. Previous studies have shown that factors such as the size of the lacrimal sac and the degree of nasal septum deviation are correlated with operative effect, but few studies have paid attention to the correlation between postoperative personal home care and surgical outcomes. [ 14 ][ 15 ] The purpose of this study was to explore the potential influencing factors for surgical outcomes in the course of postoperative personal home care, as well as the correlation between postoperative ostium conditions and subjective symptoms of patients, and provide guidance for personal home care of patients with CD. 2 Method 2.1 Participants This study prospectively included 90 patients with CD who were prepared to undergo En-DCR from August 2023 to November 2023, with a total of 94 eyes, excluding patients with other organic eye diseases, serious systemic diseases, inability to cooperate with examination and surgery, and psychiatric disorders. After admission, the patient's gender, age, medical history, previous treatment and other basic information were collected in detail, and the relevant eye examinations were completed in our hospital. The study followed the tenets of the Declaration of Helsinki and was approved by the Medical Ethics Committee of Zhongshan Eye Center, Sun Yat-sen University, Guangzhou, China (2021KYPJ100), and verbal informed consent was obtained from all subjects. 2.2 Diagnosis of Disease CD is usually secondary to PANDO, resulting in the retention of tears in the lacrimal sac, accompanied by bacterial infection. Patients present with epiphora and abscess, a swelling of the lacrimal sac. The classification of PANDO was confirmed by lacrimal duct irrigation and CT dacryocystography (CT-DCG) combined with clinical manifestations. [ 16 ] 2.3 Postoperative Management Patients can leave the hospital on the same day as their day surgery. In the course of living at home, patients were instructed to spray the nose with xylozoline hydrochloride 3 times a day(Two sprays each time)for 7 consecutive days from the first postoperative day. From the third day after operation, budesonide was sprayed on the nose 3 times a day༈Two sprays each time༉until the review one month after surgery. Starting from the first day after surgery, 300ml of water at 37℃ was poured into nasal saline rinsing salt, and the nose was washed three times a day until the review one month after surgery. [ 17 ] One month after the operation, the patients were informed to come to the hospital for reexamination by telephone. The patients were evaluated for operetive effect, dye disappearance test and lacrimal passage irrigation, and the ostium score was calculated combined with the results of nasal endoscopy [ 18 ] . At the same time, other potential factors that may affect the condition of anastomosis (such as nasal saline rinsing and spray, taking health products, respiratory tract infection, etc.) were followed up. 2.4 Surgical procedure En-DCR included disinfection of the patient in the supine position, nasal anesthesia, creation of a 1.5 cm* 1.5 cm circular incision, formation of a 1-cm-diameter bony window to expose the lacrimal sac, incision of the lacrimal sac and debridement of the inner lining, and implantation of a prosthetic tube by the attending surgeon empirically in patients with stenosis of the lacrimal tubules of the lacrimal duct as well as those who had a high risk of stomatoprosthetic obstruction postoperatively. All patients were operated on by two equally qualified senior surgeons. 2.5 Evaluation of surgical outcomes Surgical outcomes were divided into operative effect and objective indicators including lacrimal duct irrigation, dye disappearance test and ostium grade. 2.5.1 Evaluation of operative effect At present, Zhou Bing and Tang Xin's criteria are used to evaluate the efficacy of En-DCR in China, which can be divided into three grades: cured, improved and ineffective.The criteria of curative effect were as follows: 1) Cured: the patient had no symptoms of overflowing tears and pus secretion; 2) Improved: the patient still had epiphora but no pus secretion symptoms; 3) Ineffective: patients still have symptoms of epiphora and pus secretion. [ 19 ] The outcomes of surgery are divided into two parts: subjective operative effect and objective indicators. For PANDO patients, subjective operative effect should be the final indicator. 2.5.2 Evaluation of ostium MJ Ali proposed a systematic scheme and scoring system for surgeons and researchers to perform standard assessment of anastomotic status in patients after DCR. In this study, we combined this systematic approach (DOS score) to evaluate various anastomotic parameters, and the anastomotic situation was divided into 3 grades according to the final score, which were excellent, normal, and poor. [ 20 ],[ 21 ],[ 22 ] All patients were evaluated by two doctors at the same time, and the consistency was more than 95%. Patients with inconsistent results were evaluated by a third doctor. 2.6 Statistical Analysis Spss 26.0 were used for data analysis. The continuous variables following normal distribution were expressed as the mean ± standard deviation, and the categorical variables were expressed as the rate and constituent ratio.Correlation analysis was used to analyze the relationship between operative effect and objective indicators. χ2-Statistical analysis or corrected χ2-Statistical analysis was used to verify the causal relationship between ostium grade, operative effect and their influencing factors. A P value of less than 0.05 was considered to indicate statistical significance. 3 Results 3.1 Basic information A total of 94 eyes of 90 patients with chronic dacryocystitis who were scheduled for En-DCR were enrolled in this study. The average age was 55.81±12.19 years, and the average course of disease was 61.91±79.86 months. The effect of the surgery were evaluated at the one-month postoperative review, and 62 eyes were cured, 25 eyes were improved, and 7 eyes were ineffective. According to the DOS scoring system, the ostium condition of 94 eyes was divided into 3 grades (Figure 1). There were 67 people rated as excellent, 19 people rated as normal, and 8 people rated as poor. Detailed baseline data of the patients are provided in Table 1. Table 1. Baseline data of CD patients undergoing En-DCR. Parameters Number of eyes Total ， n 94（100.00） Age ， y 55.81±12.19 Course of disease ， m 61.91±79.86 Sex ， n （ % ） Male 19（20.21） Female 75（79.79） Operative effect ， n （ % ） Cured 62（65.96） Improved 25（26.60） Ineffective 7（7.45） Ostium grade ， n （ % ） Excellent 67（71.28） Normal 19（20.21） Poor 8（8.51） The results are expressed as the mean ± standard deviation (SD) or n (%) for each parameter. 3.2 Correlation between operative effect and objective indicators The results of correlation analysis between operative effect and objective indicators showed that the outcomes of lacrimal duct irrigation（r=0.444，P＜0.001）, dye disappearance test（r=0.217，P=0.036） and ostium grade（r=0.350，P＜0.001） were positively correlated with the operative effect of patients（Table 2）. This is also consistent with what we have observed clinically. Table 2. Correlation between operative effect and objective indicators Objective indicators Correlation coefficient P value Lacrimal duct irrigation 0.444 ＜0.001* Dye disappearance test 0.217 0.036* Ostium grade 0.350 ＜0.001* * Significant (P < 0.05) 3.3 Analysis of influencing factors of postoperative Ostium grade during postoperative nursing The results of influencing factors analysis of ostium grade showed that patients with nasal saline rinsing at least once a day after operation (P<0.001), nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day after operation (P=0.010) and without postoperative respiratory tract infection (P=0.041) had better ostium grades. But the results did not indicate that taking health care products（P=0.215） and blowing nose（P=0.555）contributed to ostium grade and the difference was not statistically significant（P＞0.05）. (Table 3). Table 3. χ2-Statistical analysis of postoperative Ostium grades of patients undergoing En-DCR.[number of eyes (%)] Postoperative nursing Ostium grade Total Significance Excellent Normal Poor Nasal saline rinsing （ at least once a day ） <0.001* Yes 57（79.17） 13（18.06） 2（2.78） 72（100.00） No 10（45.45） 6（27.27） 6（27.27） 22（100.00） Nasal spray frequency （ at least once a day ） 0.010* Yes 52（76.47） 14（20.59） 2（2.94） 68（100.00） No 15（57.69） 5（19.23） 6（23.08） 26（100.00） Health products 0.215 Yes 3（42.86） 3（42.86） 1（14.29） 7（100.00） No 64（73.56） 16（18.39） 7（8.05） 87（100.00） Blowing nose 0.555 Hardly 36（69.23） 11（21.15） 5（9.62） 52（100.00） Occasionally 21（72.41） 7（24.14） 1（3.45） 29（100.00） Frequently 10（76.92） 1（7.69） 2（15.38） 13（100.00） Respiratory infection 0.041* Yes 11（64.71） 2（11.76） 4（23.53） 17（100.00） No 56（72.73） 17（22.08） 4（5.19） 77（100.00） * Significant (P < 0.05) 3.4 Analysis of influencing factors of Operative effect during postoperative nursing The results of influencing factors analysis of operative effect showed that patients with nasal saline rinsing at least once a day after surgery (P=0.004), nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day (P=0.019) and no postoperative respiratory tract infection (P=0.020) had better operative effect. But the results did not indicate that taking health care products（P=0.750） and blowing nose（P=0.449）contributed to operative effect and the difference was not statistically significant（P＞0.05）. (Table 4). Table 4. Correlation analysis of postoperative Operative effect of patients undergoing En-DCR.[number of eyes (%)] Postoperative nursing Operative effect Total Significance Cured Improved Ineffective Nasal saline rinsing （ at least once a day ） 0.004* Yes 47（65.28） 23（31.94） 2（2.78） 72（100.00） No 15（68.18） 2（9.09） 5（22.27） 22（100.00） Nasal spray frequency （ at least once a day ） 0.019* Yes 45（66.18） 21（30.88） 2（2.94） 68（100.00） No 17（65.38） 4（15.38） 5（19.23） 26（100.00） Health products 0.750 Yes 4（57.14） 2（28.57） 1（14.29） 7（100.00） No 58（66.67） 23（26.44） 6（6.38） 87（100.00） Blowing nose 0.449 Hardly 35（67.31） 12（23.08） 5（9.62） 52（100.00） Occasionally 17（58.62） 11（37.93） 1（3.45） 29（100.00） Frequently 10（76.92） 2（15.38） 1（7.69） 13（100.00） Respiratory infection 0.020* Yes 9（52.94） 4（23.53） 4（23.53） 17（100.00） No 53（68.86） 21（27.27） 3（3.90） 77（100.00） * Significant (P < 0.05) 4 Discussion The treatment of PANDO, a common type of obstructive tear duct disease, often relies on En-DCR surgery as a key tool. With the boom of day surgery model, ophthalmic surgery has become the preferred choice in this field due to its advantages of being minimally invasive, highly effective and low infection rate. However, the full recovery of patients does not depend solely on the success of the surgery, but also on self-care after discharge from the hospital. Previous studies have shown that anastomotic stenosis or obstruction often stems from adhesions, anastomotic hyperplasia, and purpura [ 23 ] , which may have an impact on the surgical outcome and rely on timely detection and resolution through postoperative nasal endoscopic review and standardized personal home care. Therefore, it is particularly important to strengthen patients' postoperative personal care guidance and improve the standardization of postoperative home care. Through the preliminary clinical investigation of this study, it was found that some patients did not follow the instructions to complete a series of postoperative care processes, such as regular nasal saline rinsing and nasal spraying, and appeared to have a lack of obvious surgical results or even repeated symptoms. Since no research has pointed out the correlation between these nursing problems and operative effect, this study explored the influencing factors of En-DCR postoperative personal care on surgical outcomes including objective indicators and operative effect. The objective indicators of postoperative endoscopic reexamination were lacrimal duct irrigation, fluorescein disappearance test, and ostium grades. We combined the DOS scoring system to evaluate the ostium of patients, and according to the score, the ostium was divided into excellent, average and poor 3 grades. At the 1-month postoperative review, we found that there were 5 eyes (5/94, 5.32%) with obstructed tear duct irrigation, 6 eyes (6/94, 6.38%) with Level 3 in dye disappearance test, and 8 eyes (8/94, 8.51%) with poor ostium grade. Most of these patients complained of poor surgical results and still had tearing symptoms in the affected eyes. In order to explore the correlation with operative effect, so we correlated all objective review indicators with patients' subjective surgical outcomes, and the results showed that the outcomes of lacrimal duct irrigation(r = 0.444, P<0.001), DDT༈r = 0.217, P = 0.036༉, and ostium grade༈r = 0.350, P<0.001༉ were positively correlated with the subjective efficacy of patients. Combined with previous studies, when anastomotic stenosis or obstruction occurs due to adhesion, hyperplasia, scarring and other reasons, it often leads to poor objective indicators and also affects the operative effect [ 24 ] . Therefore, in the future review, we can use the subjective effect of the patient to evaluate the ostium condition. For patients with good subjective effect, invasive operations such as lacrimal duct irrigation can be reduced as much as possible during the review. In the subsequent analysis of influencing factors on stoma grade and surgical effect, we found that patients who maintain nasal saline rinsing and nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day and reasonably prevent respiratory tract infection tend to have better recovery of early postoperative ostium and better operative effect. Therefore, it is necessary to wash the nose regularly after surgery, which can reduce secretion accumulation and prevent anastomotic obstruction [ 25 ] . In the course of living at home, patients were instructed to spray the nose with Xylometazoline Hydrochloride and Budesonide. Xylometazoline Hydrochloride is a vasoconstrictor that stimulates constriction of small blood vessels in the nasal mucosa and reduces postoperative bleeding. Budesonide is a nasal spray containing glucocorticoids, which can inhibitory local inflammatory reactions, preventing congestion and swelling of the nasal mucosa, and improving the condition of the nasal mucosa in the vicinity of the anastomosis to prevent stoma obstruction. The results further illustrate the importance of timely nasal saline rinsing and nasal spray in the process of postoperative personal care. At the same time, it also found that respiratory tract infection has an impact on ostium grade and operative effect. Respiratory tract infections can lead to congestion, swelling, exudation, hyperplasia, atrophy, or necrosis of the nasal mucosa. Swollen nasal mucosa and exudate will squeeze and block the postoperative anastomosis [ 26 ] , which led to poor operative effect and even recurrence of symptoms. Therefore, in the postoperative home care of patients, it is important to avoid respiratory tract infection. Previous studies have shown that postoperative lacrimal duct catheterization can improve the prognosis of En-DCR [ 27 ],[ 28 ] , but the analysis results did not show that this factor has an effect on the grade of ostium(P = 0.672) and operative effect༈P = 0.684༉. In addition, at the time of postoperative endoscopic reexamination, we found that health projects༈Ginseng, Cordyceps sinensis, etc.༉had a significantly faster progression of anastomotic granulomas, but this factor did not show a significant difference in ostium grades and operative effect in the analysis. We suspect that this is due to insufficient sample size, or that these factors are not sufficient to affect stoma status in the early postoperative period. This study still has some limitations. Firstly, the sample size included in this study is limited, and the influencing factors with statistical significance need to be analyzed in combination with the clinical situation. For the influencing factors that have not been shown to be significant by statistical test, it cannot reject their possible influence. Secondly, the evaluation of the operative effect of patients mainly depends on the subjective feelings of patients. Patients with poor preoperative conditions may have better subjective surgical improvement after surgery, so there is a certain degree of uncertainty. Therefore, the associations and related results obtained in this study need to be further verified by well-designed prospective studies or trials with larger sample sizes. 5 Conclusion En-DCR is an effective surgical treatment for CD. In addition to the operation itself, postoperative personal care is also worthy of attention. Objective findings in the early postoperative period can reflect the outcome of the surgery. Among the factors of postoperative personal care, maintaining nasal saline rinse and nasal spray the nose with Xylometazoline Hydrochloride and Budesonide at least once a day, as well as preventing postoperative respiratory infections have a significant impact on the early recovery of postoperative openings, as well as affecting the patient's surgical outcome. Therefore, healthcare professionals should target and strengthen home care guidance for patients after day surgery. Declarations Foundation: This study was partly supported by the Zhongshan Ophthalmic Center 2024 Innovations in Graduate Education Project（NO.91017-12240013）. Competing Interests The authors declare that they have no conflicts of interest. Authors contributions Xinyu Zheng, and Yunming Liu made substantial contributions to the study conception, acquisition and interpretation of the data and manuscript drafting. Xinyue Yu and Kerui Wang contributed to and acquired the data and reviewed the manuscript. Ziwei Meng and Jing Li contributed to the analysis of the data. Rongxin Chen and Xuanwei Liang contributed to the supervision of the study, and review of the manuscript. Yang Can and Chengzhen Gong contributed to the completion of patients' informed consent forms and and the collection and electronicization of documents. Rongxin Chen and Shuiling Li were accountable for the design of the study, manuscript drafting, the project funding, the integrity and accuracy of the work, and critical review. All authors approved the version of the manuscript to be published. Ethics approval This study was approved by the Institutional Review Board of the Zhongshan Ophthalmic Center, Sun Yat-sen University, China (No. 2021KYPJ100) and adhered to the tenets of the Declaration of Helsinki. Consent to participate Informed consent was obtained from all subjects involved in the study. Written informed consent for the publication of this paper was obtained from the patients. References Wang, X., Chen, X., Hao, Y., Wang, Y., Zhao, J., Sun, H., Zheng, M., & Zhang, L. (2021). Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery, 35(8), 677–682. https://doi.org/10.13201/j.issn.2096-7993.2021.08.002 Wang, G., Jin, H., Sheng, Y., Ji, F., Liu, Y., Han, L., Wang, X., Chen, X., Ding, H., Liu, J., & Fu, Q. (2024). Higher incidence of meibomian gland dysfunction in postmenopausal women with primary acquired nasolacrimal duct obstruction. International ophthalmology, 44(1), 70. https://doi.org/10.1007/s10792-024-03041-9 Atkova, E. L., Yartsev, V. D., Ekaterinchev, M. A., & Shkolyarenko, N. Y. (2023). Biometricheskie kharakteristiki slezootvodyashchikh putei v norme i pri dakriostenoze [Biometric characteristics of the lacrimal passages in healthy individuals and in patients with nasolacrimal duct obstruction]. Vestnik oftalmologii, 139(5), 20–26. https://doi.org/10.17116/oftalma202313905120. Li, M., Li, W., Sha, Q., Yu, L., & Wang, X. (2024). Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis. Medicine, 103(3), e36934. https://doi.org/10.1097/MD.0000000000036934 Watkins, L. M., Janfaza, P., & Rubin, P. A. (2003). The evolution of endonasal dacryocystorhinostomy. Survey of ophthalmology, 48(1), 73–84. https://doi.org/10.1016/s0039-6257(02)00397-1. Vinciguerra, A., Indelicato, P., Giordano Resti, A., Bussi, M., & Trimarchi, M. (2022). Long-term results of a balloon-assisted endoscopic approach in failed dacryocystorhinostomies. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 279(4), 1929–1935. https://doi.org/10.1007/s00405-021-06975-3. Kumar, S., Mishra, A. K., Sethi, A., Mallick, A., Maggon, N., Sharma, H., & Gupta, A. (2019). Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 160(2), 347–354. https://doi.org/10.1177/0194599818813123. Mudhol, R. R., Zingade, N. D., Mudhol, R. S., Harugop, A. S., & Das, A. T. (2013). Prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 65(Suppl 2), 255–259. https://doi.org/10.1007/s12070-011-0409-1. The international association for ambulatory surgery. Daily surgery handbook[EB/OL]. [2020-09-22]. https:// www.iaas-med.com/files/2013/Day_Surgery_Manual.pdf. Vinciguerra, A., Nonis, A., Resti, A. G., Bussi, M., & Trimarchi, M. (2020). Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis. American journal of rhinology & allergy, 34(6), 846–856. https://doi.org/10.1177/1945892420945218. Ali, M. J., Psaltis, A. J., Ali, M. H., & Wormald, P. J. (2015). Endoscopic assessment of the dacryocystorhinostomy ostium after powered endoscopic surgery: behaviour beyond 4 weeks. Clinical & experimental ophthalmology, 43(2), 152–155. https://doi.org/10.1111/ceo.12383. Orsolini, M. J., Schellini, S. A., Souza Meneguim, R. L. F., & Catâneo, A. J. M. (2020). Success of endoscopic dacryocystorhinostomy with or without stents: systematic review and meta-analysis. Orbit (Amsterdam, Netherlands), 39(4), 258–265. https://doi.org/10.1080/01676830.2019.1677726. Grob, S. R., Campbell, A., Lefebvre, D. R., & Yoon, M. K. (2015). External Versus Endoscopic Endonasal Dacryocystorhinostomy. International ophthalmology clinics, 55(4), 51–62. https://doi.org/10.1097/IIO.0000000000000083. Pandya, V. B., Lee, S., Benger, R., Danks, J. J., Kourt, G., Martin, P. A., Lertsumitkul, S., McCluskey, P., & Ghabrial, R. (2010). External dacryocystorhinostomy: assessing factors that influence outcome. Orbit (Amsterdam, Netherlands), 29(5), 291–297. https://doi.org/10.3109/01676830.2010.485715 Liu, S., Zhang, H., Zhang, Y. R., Chen, L. J., & Yu, X. Y. (2024). The efficacy of endoscopic dacryocystorhinostomy in the treatment of dacryocystitis: A systematic review and meta-analysis. Medicine, 103(11), e37312. https://doi.org/10.1097/MD.0000000000037312. Eshraghi, B., Abdi, P., Akbari, M., & Fard, M. A. (2014). Microbiologic spectrum of acute and chronic dacryocystitis. International journal of ophthalmology, 7(5), 864–867. https://doi.org/10.3980/j.issn.2222-3959.2014.05.23. Ullrich K, Malhotra R, Patel BC. Dacryocystorhinostomy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 7, 2023. Shen, X., Huang, C., Wang, S., & Wen, J. (2024). Optimisation of reduction for prolapsed silicone tube after lacrimal intubation. The Journal of laryngology and otology, 138(5), 535–539. https://doi.org/10.1017/S0022215123001706. Li, M., Li, W., Sha, Q., Yu, L., & Wang, X. (2024). Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis. Medicine, 103(3), e36934. https://doi.org/10.1097/MD.0000000000036934. Ali, M. J., Psaltis, A. J., & Wormald, P. J. (2014). Dacryocystorhinostomy ostium: parameters to evaluate and DCR ostium scoring. Clinical ophthalmology (Auckland, N.Z.), 8, 2491–2499. https://doi.org/10.2147/OPTH.S73998. Tadke, K., Lahane, V., & Lokhande, P. (2022). Ostium Characteristics and Its Relevance in Successful Outcome Following Endoscopic Dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 2), 900–910. https://doi.org/10.1007/s12070-020-01970-2. Al Huthail, R. R., & Al-Faky, Y. H. (2021). Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy. European journal of ophthalmology, 31(6), 3425–3429. https://doi.org/10.1177/1120672120976044. LIU Nan, PANG Mingjie. Review of factors influencing the prognosis of endoscopic dacryocystorhinostomy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 149-155. Shin, H. Y., Paik, J. S., & Yang, S. W. (2018). Clinical Results of Anti-adhesion Adjuvants after Endonasal Dacryocystorhinostomy. Korean journal of ophthalmology : KJO, 32(6), 433–437. https://doi.org/10.3341/kjo.2017.0124. Tadke, K., Lahane, V., & Lokhande, P. (2022). Ostium Characteristics and Its Relevance in Successful Outcome Following Endoscopic Dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 2), 900–910. https://doi.org/10.1007/s12070-020-01970-2. Soriano, L. M., Damasceno, N. A., Herzog Neto, G., & Damasceno, E. F. (2019). Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy. Clinical ophthalmology (Auckland, N.Z.), 13, 1267–1271. https://doi.org/10.2147/OPTH.S200923. Evereklioglu C. (2020). Primary Probing with and without Monoka Silastic Stent Intubation for Epiphora in Older Children and Adults. Current eye research, 45(1), 87–90. https://doi.org/10.1080/02713683.2019.1643026. Orsolini, M. J., Schellini, S. A., Souza Meneguim, R. L. F., & Catâneo, A. J. M. (2020). Success of endoscopic dacryocystorhinostomy with or without stents: systematic review and meta-analysis. Orbit (Amsterdam, Netherlands), 39(4), 258–265. https://doi.org/10.1080/01676830.2019.1677726. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 13 Feb, 2025 Reviews received at journal 10 Feb, 2025 Reviews received at journal 03 Feb, 2025 Reviewers agreed at journal 31 Jan, 2025 Reviewers agreed at journal 30 Jan, 2025 Reviewers agreed at journal 29 Jan, 2025 Reviewers invited by journal 29 Jan, 2025 Editor assigned by journal 21 Jan, 2025 Submission checks completed at journal 21 Jan, 2025 First submitted to journal 19 Jan, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5858763","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":405089497,"identity":"0c0bab8a-8678-45ed-be69-6f6024be66f7","order_by":0,"name":"Xinyu Zheng","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Xinyu","middleName":"","lastName":"Zheng","suffix":""},{"id":405089498,"identity":"8e506efd-85aa-4646-a7f3-a6af9f66090d","order_by":1,"name":"Yunming Liu","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Yunming","middleName":"","lastName":"Liu","suffix":""},{"id":405089499,"identity":"ae07c003-9abc-4f2c-81be-5388223aaab3","order_by":2,"name":"Xinyue Yu","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Xinyue","middleName":"","lastName":"Yu","suffix":""},{"id":405089500,"identity":"6e9c95a0-775a-43ca-9a77-1e199cd6d4f3","order_by":3,"name":"Kerui Wang","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Kerui","middleName":"","lastName":"Wang","suffix":""},{"id":405089501,"identity":"3982443a-dd55-4e80-9e80-703fd231f67b","order_by":4,"name":"Ziwei Meng","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Ziwei","middleName":"","lastName":"Meng","suffix":""},{"id":405089502,"identity":"222f3619-a734-46a2-9912-7e7ce98a8b1d","order_by":5,"name":"Jing Li","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Jing","middleName":"","lastName":"Li","suffix":""},{"id":405089504,"identity":"4be0b6e0-ed6f-4f24-b87f-891e85e6b5f3","order_by":6,"name":"Can Yang","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Can","middleName":"","lastName":"Yang","suffix":""},{"id":405089506,"identity":"8280614c-138e-4ecc-888e-936615611612","order_by":7,"name":"Chengzhen Gong","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Chengzhen","middleName":"","lastName":"Gong","suffix":""},{"id":405089508,"identity":"b3bafee0-688b-41c6-b7b7-79a2947a016f","order_by":8,"name":"Xuanwei Liang","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Xuanwei","middleName":"","lastName":"Liang","suffix":""},{"id":405089510,"identity":"2abac3e8-69db-4eba-afd2-5dd605efbdee","order_by":9,"name":"Rongxin Chen","email":"","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":false,"prefix":"","firstName":"Rongxin","middleName":"","lastName":"Chen","suffix":""},{"id":405089511,"identity":"2a478ffe-1ed6-4aff-8201-c6fcf2770194","order_by":10,"name":"Shuiling Li","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYBACPmYGNgYGAwseBgbmA8RpYYNokQBqYUsgUgsYMUgAMY8BkVrY2Z895imQkDHnX/P55Y8/NvIM7IePbsDvMB5zYx6gwyxnvN1mIcGTZtjAk5Z2g4AWNmmQFoMbZ7cZGEgcTmCQ4DEjoIX9GVTLmWcGCQZEaWEwg2g538P84EACUVp4zCTngG1hM2NsOJBm2EbIL/z8x59JvPljY29w/vDjj6AQ42c/fAyvFgSQSGCTANtLnHKwfQeYPxCvehSMglEwCkYSAAB8GzxI8A/PvwAAAABJRU5ErkJggg==","orcid":"","institution":"Sun Yat-sen University","correspondingAuthor":true,"prefix":"","firstName":"Shuiling","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2025-01-19 09:53:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5858763/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5858763/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75308387,"identity":"9cc0a3fa-7bf4-49cc-a515-6146ea272d69","added_by":"auto","created_at":"2025-02-03 08:47:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":461957,"visible":true,"origin":"","legend":"\u003cp\u003eThe above are examples of the three grades of the ostium. Picture A shows the ostium with excellent grade, picture B shows the ostium with normal grade, and picture C shows the ostium with poor grade.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-5858763/v1/d1edd525ee66daee95b72628.png"},{"id":75310488,"identity":"a36dad48-74f7-49b0-8fb4-81f78a30326b","added_by":"auto","created_at":"2025-02-03 09:03:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1628747,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5858763/v1/773ed220-cd0b-40f5-acc5-8afc05c26a01.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of the influence of postoperative personal care on the surgical outcomes of endoscopic dacryocystorhinostomy","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eChronic dacryocystitis (CD), mainly caused by primary acquired nasolacrimal duct obstruction (PANDO), is a common ocular inflammatory disease and ocular and nasal related diseases in ophthalmology. It is often manifested by ocular epiphora, pus discharge, skin redness and pain in the lacrimal sac area.\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e],[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e Currently, the pathogenesis of PANDO remains unclear, and patients typically seek medical attention only when their condition is severe, necessitating surgical treatment.\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e],[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e Dacryocystorhinostomy is currently a surgical method for CD, which mainly includes transdermal dacryocystorhinostomy(Ex-DCR)and nasal endoscopic dacryocystorhinostomy༈En-DCR༉.\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e],[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e Currently, the success rate of En-DCR can be close to or even exceed that of traditional Ex-DCR .\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e Due to the advantages of minimal surgical trauma, reduced bleeding and absence of facial scarring, En-DCR was gradually preferred by patients.\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eDay surgery is a rapidly developing medical service mode. Ophthalmology is more suitable for day surgery due to its characteristics of disease diagnosis and treatment.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003e In addition to the success of the operation itself, personal home care of patients is also a very important part of postoperative rehabilitation.\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003e It has been reported that the ostium will shrink significantly within 4 weeks after operation,\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e and postoperative ostium stenosis is one of the important reasons affecting the surgical efficacy of En-DCR, and nasal endoscopy should be performed regularly.\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eAt present, guidelines and expert consensus have clarified the necessity of nasal endoscopic reexamination after En-DCR,\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e but it is not clear whether objective indicators are related to the subjective surgical effect of patients. After clinical investigation, in addition to regular nasal saline rinsing and medication, some patients have other nursing problems that may affect the condition of nasal cavity after surgery, such as blowing nose, taking health care products(Ginseng, Cordyceps sinensis, etc.), postoperative respiratory tract infection and so on, which may affect the recovery of postoperative ostium. Previous studies have shown that factors such as the size of the lacrimal sac and the degree of nasal septum deviation are correlated with operative effect, but few studies have paid attention to the correlation between postoperative personal home care and surgical outcomes.\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e][\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe purpose of this study was to explore the potential influencing factors for surgical outcomes in the course of postoperative personal home care, as well as the correlation between postoperative ostium conditions and subjective symptoms of patients, and provide guidance for personal home care of patients with CD.\u003c/p\u003e"},{"header":"2 Method","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Participants\u003c/h2\u003e \u003cp\u003eThis study prospectively included 90 patients with CD who were prepared to undergo En-DCR from August 2023 to November 2023, with a total of 94 eyes, excluding patients with other organic eye diseases, serious systemic diseases, inability to cooperate with examination and surgery, and psychiatric disorders. After admission, the patient's gender, age, medical history, previous treatment and other basic information were collected in detail, and the relevant eye examinations were completed in our hospital.\u003c/p\u003e \u003cp\u003e The study followed the tenets of the Declaration of Helsinki and was approved by the Medical Ethics Committee of Zhongshan Eye Center, Sun Yat-sen University, Guangzhou, China (2021KYPJ100), and verbal informed consent was obtained from all subjects.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Diagnosis of Disease\u003c/h2\u003e \u003cp\u003eCD is usually secondary to PANDO, resulting in the retention of tears in the lacrimal sac, accompanied by bacterial infection. Patients present with epiphora and abscess, a swelling of the lacrimal sac. The classification of PANDO was confirmed by lacrimal duct irrigation and CT dacryocystography (CT-DCG) combined with clinical manifestations.\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Postoperative Management\u003c/h2\u003e \u003cp\u003ePatients can leave the hospital on the same day as their day surgery. In the course of living at home, patients were instructed to spray the nose with xylozoline hydrochloride 3 times a day(Two sprays each time)for 7 consecutive days from the first postoperative day. From the third day after operation, budesonide was sprayed on the nose 3 times a day༈Two sprays each time༉until the review one month after surgery. Starting from the first day after surgery, 300ml of water at 37℃ was poured into nasal saline rinsing salt, and the nose was washed three times a day until the review one month after surgery.\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOne month after the operation, the patients were informed to come to the hospital for reexamination by telephone. The patients were evaluated for operetive effect, dye disappearance test and lacrimal passage irrigation, and the ostium score was calculated combined with the results of nasal endoscopy\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e. At the same time, other potential factors that may affect the condition of anastomosis (such as nasal saline rinsing and spray, taking health products, respiratory tract infection, etc.) were followed up.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Surgical procedure\u003c/h2\u003e \u003cp\u003eEn-DCR included disinfection of the patient in the supine position, nasal anesthesia, creation of a 1.5 cm* 1.5 cm circular incision, formation of a 1-cm-diameter bony window to expose the lacrimal sac, incision of the lacrimal sac and debridement of the inner lining, and implantation of a prosthetic tube by the attending surgeon empirically in patients with stenosis of the lacrimal tubules of the lacrimal duct as well as those who had a high risk of stomatoprosthetic obstruction postoperatively. All patients were operated on by two equally qualified senior surgeons.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Evaluation of surgical outcomes\u003c/h2\u003e \u003cp\u003eSurgical outcomes were divided into operative effect and objective indicators including lacrimal duct irrigation, dye disappearance test and ostium grade.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.5.1 Evaluation of operative effect\u003c/h2\u003e \u003cp\u003eAt present, Zhou Bing and Tang Xin's criteria are used to evaluate the efficacy of En-DCR in China, which can be divided into three grades: cured, improved and ineffective.The criteria of curative effect were as follows: 1) Cured: the patient had no symptoms of overflowing tears and pus secretion; 2) Improved: the patient still had epiphora but no pus secretion symptoms; 3) Ineffective: patients still have symptoms of epiphora and pus secretion.\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e The outcomes of surgery are divided into two parts: subjective operative effect and objective indicators. For PANDO patients, subjective operative effect should be the final indicator.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.5.2 Evaluation of ostium\u003c/h2\u003e \u003cp\u003eMJ Ali proposed a systematic scheme and scoring system for surgeons and researchers to perform standard assessment of anastomotic status in patients after DCR. In this study, we combined this systematic approach (DOS score) to evaluate various anastomotic parameters, and the anastomotic situation was divided into 3 grades according to the final score, which were excellent, normal, and poor.\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e],[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e],[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e All patients were evaluated by two doctors at the same time, and the consistency was more than 95%. Patients with inconsistent results were evaluated by a third doctor.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Statistical Analysis\u003c/h2\u003e \u003cp\u003eSpss 26.0 were used for data analysis. The continuous variables following normal distribution were expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, and the categorical variables were expressed as the rate and constituent ratio.Correlation analysis was used to analyze the relationship between operative effect and objective indicators. χ2-Statistical analysis or corrected χ2-Statistical analysis was used to verify the causal relationship between ostium grade, operative effect and their influencing factors. A P value of less than 0.05 was considered to indicate statistical significance.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Basic information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 94 eyes of 90 patients with chronic dacryocystitis who were scheduled for En-DCR were enrolled in this study. The average age was 55.81\u0026plusmn;12.19 years, and the average course of disease was 61.91\u0026plusmn;79.86 months. The effect of the surgery were evaluated at the one-month postoperative review, and 62 eyes were cured, 25 eyes were improved, and 7 eyes were ineffective. According to the DOS scoring system, the ostium condition of 94 eyes was divided into 3 grades (Figure 1). There were 67 people rated as excellent, 19 people rated as normal, and 8 people rated as poor. Detailed baseline data of the patients are provided in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e\u0026nbsp; \u0026nbsp;Baseline data of CD patients undergoing En-DCR.\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of eyes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e94（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003ey\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e55.81\u0026plusmn;12.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCourse of disease\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003em\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e61.91\u0026plusmn;79.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e19（20.21）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e75（79.79）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOperative effect\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eCured\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e62（65.96）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eImproved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e25（26.60）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eIneffective\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e7（7.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOstium grade\u003c/strong\u003e\u003cstrong\u003e，\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e67（71.28）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e19（20.21）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 190px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 134px;\"\u003e\n \u003cp\u003e8（8.51）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe results are expressed as the mean \u0026plusmn; standard deviation (SD) or n (%) for each parameter.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Correlation between operative effect and objective indicators\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of correlation analysis between operative effect and objective indicators showed that the outcomes of lacrimal duct irrigation（r=0.444，P＜0.001）, dye disappearance test（r=0.217，P=0.036）\u0026nbsp;and ostium grade（r=0.350，P＜0.001）\u0026nbsp;were positively correlated with the operative effect of patients（Table 2）. This is also consistent with what we have observed clinically.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e\u0026nbsp; Correlation between operative effect and objective indicators\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eObjective indicators\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003eCorrelation coefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eLacrimal duct irrigation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003e0.444\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eDye disappearance test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003e0.217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e0.036*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 224px;\"\u003e\n \u003cp\u003eOstium grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 240px;\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e＜0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e* Significant (P \u0026lt; 0.05)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Analysis of influencing factors of postoperative Ostium grade during postoperative nursing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of influencing factors analysis of ostium grade showed that patients with nasal saline rinsing at least once a day after operation (P\u0026lt;0.001), nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day after operation (P=0.010) and without postoperative respiratory tract infection (P=0.041) had better ostium grades. But the results did not indicate that taking health care products（P=0.215）\u0026nbsp;and blowing nose（P=0.555）contributed to ostium grade and the difference was not statistically significant（P＞0.05）. (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u003c/strong\u003e\u0026nbsp; \u0026chi;2-Statistical analysis of postoperative Ostium grades of patients undergoing En-DCR.[number of eyes (%)]\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"598\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003ePostoperative nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003eOstium grade\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eSignificance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNasal saline rinsing\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eat least once a day\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e57（79.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e13（18.06）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2（2.78）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e72（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e10（45.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e6（27.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6（27.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e22（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNasal spray frequency\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eat least once a day\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.010*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e52（76.47）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e14（20.59）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2（2.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e68（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e15（57.69）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e5（19.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6（23.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e26（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth products\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e3（42.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e3（42.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1（14.29）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e7（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e64（73.56）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e16（18.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e7（8.05）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e87（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlowing nose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.555\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eHardly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e36（69.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e11（21.15）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e5（9.62）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e52（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e21（72.41）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e7（24.14）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e1（3.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e29（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eFrequently\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e10（76.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1（7.69）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e2（15.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e13（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory infection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e11（64.71）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2（11.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4（23.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e17（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 175px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 86px;\"\u003e\n \u003cp\u003e56（72.73）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e17（22.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 84px;\"\u003e\n \u003cp\u003e4（5.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e77（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e* Significant (P \u0026lt; 0.05)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 \u0026nbsp; Analysis of influencing factors of Operative effect during postoperative nursing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe results of influencing factors analysis of operative effect showed that patients with nasal saline rinsing at least once a day after surgery (P=0.004), nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day (P=0.019) and no postoperative respiratory tract infection (P=0.020) had better operative effect. But the results did not indicate that taking health care products（P=0.750）\u0026nbsp;and blowing nose（P=0.449）contributed to operative effect and the difference was not statistically significant（P＞0.05）. (Table 4).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eCorrelation analysis of postoperative Operative effect of patients undergoing En-DCR.[number of eyes (%)]\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"576\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003ePostoperative nursing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 245px;\"\u003e\n \u003cp\u003eOperative effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003eSignificance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003eCured\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003eImproved\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003eIneffective\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNasal saline rinsing\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eat least once a day\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e47（65.28）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e23（31.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2（2.78）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e72（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e15（68.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e2（9.09）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e5（22.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e22（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNasal spray frequency\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eat least once a day\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.019*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e45（66.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e21（30.88）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e2（2.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e68（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e17（65.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e4（15.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e5（19.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e26（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth products\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.750\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e4（57.14）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e2（28.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e1（14.29）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e7（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e58（66.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e23（26.44）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e6（6.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e87（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlowing nose\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.449\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eHardly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e35（67.31）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e12（23.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e5（9.62）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e52（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eOccasionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e17（58.62）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e11（37.93）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e1（3.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e29（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eFrequently\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e10（76.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 82px;\"\u003e\n \u003cp\u003e2（15.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 81px;\"\u003e\n \u003cp\u003e1（7.69）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e13（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory infection\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.020*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e9（52.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e4（23.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e4（23.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e17（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e53（68.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 82px;\"\u003e\n \u003cp\u003e21（27.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 81px;\"\u003e\n \u003cp\u003e3（3.90）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 80px;\"\u003e\n \u003cp\u003e77（100.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e* Significant (P \u0026lt; 0.05)\u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThe treatment of PANDO, a common type of obstructive tear duct disease, often relies on En-DCR surgery as a key tool. With the boom of day surgery model, ophthalmic surgery has become the preferred choice in this field due to its advantages of being minimally invasive, highly effective and low infection rate. However, the full recovery of patients does not depend solely on the success of the surgery, but also on self-care after discharge from the hospital. Previous studies have shown that anastomotic stenosis or obstruction often stems from adhesions, anastomotic hyperplasia, and purpura\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003e, which may have an impact on the surgical outcome and rely on timely detection and resolution through postoperative nasal endoscopic review and standardized personal home care. Therefore, it is particularly important to strengthen patients' postoperative personal care guidance and improve the standardization of postoperative home care.\u003c/p\u003e \u003cp\u003eThrough the preliminary clinical investigation of this study, it was found that some patients did not follow the instructions to complete a series of postoperative care processes, such as regular nasal saline rinsing and nasal spraying, and appeared to have a lack of obvious surgical results or even repeated symptoms. Since no research has pointed out the correlation between these nursing problems and operative effect, this study explored the influencing factors of En-DCR postoperative personal care on surgical outcomes including objective indicators and operative effect.\u003c/p\u003e \u003cp\u003eThe objective indicators of postoperative endoscopic reexamination were lacrimal duct irrigation, fluorescein disappearance test, and ostium grades. We combined the DOS scoring system to evaluate the ostium of patients, and according to the score, the ostium was divided into excellent, average and poor 3 grades. At the 1-month postoperative review, we found that there were 5 eyes (5/94, 5.32%) with obstructed tear duct irrigation, 6 eyes (6/94, 6.38%) with Level 3 in dye disappearance test, and 8 eyes (8/94, 8.51%) with poor ostium grade. Most of these patients complained of poor surgical results and still had tearing symptoms in the affected eyes. In order to explore the correlation with operative effect, so we correlated all objective review indicators with patients' subjective surgical outcomes, and the results showed that the outcomes of lacrimal duct irrigation(r\u0026thinsp;=\u0026thinsp;0.444, P\u0026lt;0.001), DDT༈r\u0026thinsp;=\u0026thinsp;0.217, P\u0026thinsp;=\u0026thinsp;0.036༉, and ostium grade༈r\u0026thinsp;=\u0026thinsp;0.350, P\u0026lt;0.001༉ were positively correlated with the subjective efficacy of patients. Combined with previous studies, when anastomotic stenosis or obstruction occurs due to adhesion, hyperplasia, scarring and other reasons, it often leads to poor objective indicators and also affects the operative effect\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e. Therefore, in the future review, we can use the subjective effect of the patient to evaluate the ostium condition. For patients with good subjective effect, invasive operations such as lacrimal duct irrigation can be reduced as much as possible during the review.\u003c/p\u003e \u003cp\u003eIn the subsequent analysis of influencing factors on stoma grade and surgical effect, we found that patients who maintain nasal saline rinsing and nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day and reasonably prevent respiratory tract infection tend to have better recovery of early postoperative ostium and better operative effect. Therefore, it is necessary to wash the nose regularly after surgery, which can reduce secretion accumulation and prevent anastomotic obstruction\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/sup\u003e. In the course of living at home, patients were instructed to spray the nose with Xylometazoline Hydrochloride and Budesonide. Xylometazoline Hydrochloride is a vasoconstrictor that stimulates constriction of small blood vessels in the nasal mucosa and reduces postoperative bleeding. Budesonide is a nasal spray containing glucocorticoids, which can inhibitory local inflammatory reactions, preventing congestion and swelling of the nasal mucosa, and improving the condition of the nasal mucosa in the vicinity of the anastomosis to prevent stoma obstruction. The results further illustrate the importance of timely nasal saline rinsing and nasal spray in the process of postoperative personal care. At the same time, it also found that respiratory tract infection has an impact on ostium grade and operative effect. Respiratory tract infections can lead to congestion, swelling, exudation, hyperplasia, atrophy, or necrosis of the nasal mucosa. Swollen nasal mucosa and exudate will squeeze and block the postoperative anastomosis\u003csup\u003e[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e, which led to poor operative effect and even recurrence of symptoms. Therefore, in the postoperative home care of patients, it is important to avoid respiratory tract infection.\u003c/p\u003e \u003cp\u003ePrevious studies have shown that postoperative lacrimal duct catheterization can improve the prognosis of En-DCR\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e],[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e, but the analysis results did not show that this factor has an effect on the grade of ostium(P\u0026thinsp;=\u0026thinsp;0.672) and operative effect༈P\u0026thinsp;=\u0026thinsp;0.684༉. In addition, at the time of postoperative endoscopic reexamination, we found that health projects༈Ginseng, Cordyceps sinensis, etc.༉had a significantly faster progression of anastomotic granulomas, but this factor did not show a significant difference in ostium grades and operative effect in the analysis. We suspect that this is due to insufficient sample size, or that these factors are not sufficient to affect stoma status in the early postoperative period.\u003c/p\u003e \u003cp\u003eThis study still has some limitations. Firstly, the sample size included in this study is limited, and the influencing factors with statistical significance need to be analyzed in combination with the clinical situation. For the influencing factors that have not been shown to be significant by statistical test, it cannot reject their possible influence. Secondly, the evaluation of the operative effect of patients mainly depends on the subjective feelings of patients. Patients with poor preoperative conditions may have better subjective surgical improvement after surgery, so there is a certain degree of uncertainty. Therefore, the associations and related results obtained in this study need to be further verified by well-designed prospective studies or trials with larger sample sizes.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eEn-DCR is an effective surgical treatment for CD. In addition to the operation itself, postoperative personal care is also worthy of attention. Objective findings in the early postoperative period can reflect the outcome of the surgery. Among the factors of postoperative personal care, maintaining nasal saline rinse and nasal spray the nose with Xylometazoline Hydrochloride and Budesonide at least once a day, as well as preventing postoperative respiratory infections have a significant impact on the early recovery of postoperative openings, as well as affecting the patient's surgical outcome. Therefore, healthcare professionals should target and strengthen home care guidance for patients after day surgery.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFoundation:\u0026nbsp;\u003c/strong\u003eThis study was partly supported by the Zhongshan Ophthalmic Center 2024 Innovations in Graduate Education Project（NO.91017-12240013）.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eXinyu Zheng, and Yunming Liu made substantial contributions to the study conception, acquisition and interpretation of the data and manuscript drafting. Xinyue Yu and Kerui Wang contributed to and acquired the data and reviewed the manuscript. \u0026nbsp; Ziwei Meng and Jing Li contributed to the analysis of the data. Rongxin Chen and Xuanwei Liang contributed to the supervision of the study, and review of the manuscript. Yang Can and Chengzhen Gong contributed to the completion of patients' informed consent forms and and the collection and electronicization of documents. Rongxin Chen and Shuiling Li were accountable for the design of the study, manuscript drafting, the project funding, the integrity and accuracy of the work, and critical review. All authors approved the version of the manuscript to be published.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board of the Zhongshan Ophthalmic Center, Sun Yat-sen University, China (No. 2021KYPJ100) and adhered to the tenets of the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all subjects involved in the study. Written informed consent for the publication of this paper was obtained from the patients.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWang, X., Chen, X., Hao, Y., Wang, Y., Zhao, J., Sun, H., Zheng, M., \u0026amp; Zhang, L. (2021). Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery, 35(8), 677\u0026ndash;682. https://doi.org/10.13201/j.issn.2096-7993.2021.08.002 \u003c/li\u003e\n\u003cli\u003eWang, G., Jin, H., Sheng, Y., Ji, F., Liu, Y., Han, L., Wang, X., Chen, X., Ding, H., Liu, J., \u0026amp; Fu, Q. (2024). Higher incidence of meibomian gland dysfunction in postmenopausal women with primary acquired nasolacrimal duct obstruction. International ophthalmology, 44(1), 70. https://doi.org/10.1007/s10792-024-03041-9 \u003c/li\u003e\n\u003cli\u003eAtkova, E. L., Yartsev, V. D., Ekaterinchev, M. A., \u0026amp; Shkolyarenko, N. Y. (2023). Biometricheskie kharakteristiki slezootvodyashchikh putei v norme i pri dakriostenoze [Biometric characteristics of the lacrimal passages in healthy individuals and in patients with nasolacrimal duct obstruction]. Vestnik oftalmologii, 139(5), 20\u0026ndash;26. https://doi.org/10.17116/oftalma202313905120.\u003c/li\u003e\n\u003cli\u003eLi, M., Li, W., Sha, Q., Yu, L., \u0026amp; Wang, X. (2024). Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis. Medicine, 103(3), e36934. https://doi.org/10.1097/MD.0000000000036934 \u003c/li\u003e\n\u003cli\u003eWatkins, L. M., Janfaza, P., \u0026amp; Rubin, P. A. (2003). The evolution of endonasal dacryocystorhinostomy. Survey of ophthalmology, 48(1), 73\u0026ndash;84. https://doi.org/10.1016/s0039-6257(02)00397-1. \u003c/li\u003e\n\u003cli\u003eVinciguerra, A., Indelicato, P., Giordano Resti, A., Bussi, M., \u0026amp; Trimarchi, M. (2022). Long-term results of a balloon-assisted endoscopic approach in failed dacryocystorhinostomies. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 279(4), 1929\u0026ndash;1935. https://doi.org/10.1007/s00405-021-06975-3. \u003c/li\u003e\n\u003cli\u003eKumar, S., Mishra, A. K., Sethi, A., Mallick, A., Maggon, N., Sharma, H., \u0026amp; Gupta, A. (2019). Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 160(2), 347\u0026ndash;354. https://doi.org/10.1177/0194599818813123. \u003c/li\u003e\n\u003cli\u003eMudhol, R. R., Zingade, N. D., Mudhol, R. S., Harugop, A. S., \u0026amp; Das, A. T. (2013). Prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 65(Suppl 2), 255\u0026ndash;259. https://doi.org/10.1007/s12070-011-0409-1. \u003c/li\u003e\n\u003cli\u003eThe international association for ambulatory surgery. Daily surgery handbook[EB/OL]. [2020-09-22]. https:// www.iaas-med.com/files/2013/Day_Surgery_Manual.pdf.\u003c/li\u003e\n\u003cli\u003eVinciguerra, A., Nonis, A., Resti, A. G., Bussi, M., \u0026amp; Trimarchi, M. (2020). Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis. American journal of rhinology \u0026amp; allergy, 34(6), 846\u0026ndash;856. https://doi.org/10.1177/1945892420945218. \u003c/li\u003e\n\u003cli\u003eAli, M. J., Psaltis, A. J., Ali, M. H., \u0026amp; Wormald, P. J. (2015). Endoscopic assessment of the dacryocystorhinostomy ostium after powered endoscopic surgery: behaviour beyond 4 weeks. Clinical \u0026amp; experimental ophthalmology, 43(2), 152\u0026ndash;155. https://doi.org/10.1111/ceo.12383. \u003c/li\u003e\n\u003cli\u003eOrsolini, M. J., Schellini, S. A., Souza Meneguim, R. L. F., \u0026amp; Cat\u0026acirc;neo, A. J. M. (2020). Success of endoscopic dacryocystorhinostomy with or without stents: systematic review and meta-analysis. Orbit (Amsterdam, Netherlands), 39(4), 258\u0026ndash;265. https://doi.org/10.1080/01676830.2019.1677726. \u003c/li\u003e\n\u003cli\u003eGrob, S. R., Campbell, A., Lefebvre, D. R., \u0026amp; Yoon, M. K. (2015). External Versus Endoscopic Endonasal Dacryocystorhinostomy. International ophthalmology clinics, 55(4), 51\u0026ndash;62. https://doi.org/10.1097/IIO.0000000000000083. \u003c/li\u003e\n\u003cli\u003ePandya, V. B., Lee, S., Benger, R., Danks, J. J., Kourt, G., Martin, P. A., Lertsumitkul, S., McCluskey, P., \u0026amp; Ghabrial, R. (2010). External dacryocystorhinostomy: assessing factors that influence outcome. Orbit (Amsterdam, Netherlands), 29(5), 291\u0026ndash;297. https://doi.org/10.3109/01676830.2010.485715\u003c/li\u003e\n\u003cli\u003eLiu, S., Zhang, H., Zhang, Y. R., Chen, L. J., \u0026amp; Yu, X. Y. (2024). The efficacy of endoscopic dacryocystorhinostomy in the treatment of dacryocystitis: A systematic review and meta-analysis. Medicine, 103(11), e37312. https://doi.org/10.1097/MD.0000000000037312. \u003c/li\u003e\n\u003cli\u003eEshraghi, B., Abdi, P., Akbari, M., \u0026amp; Fard, M. A. (2014). Microbiologic spectrum of acute and chronic dacryocystitis. International journal of ophthalmology, 7(5), 864\u0026ndash;867. https://doi.org/10.3980/j.issn.2222-3959.2014.05.23. \u003c/li\u003e\n\u003cli\u003eUllrich K, Malhotra R, Patel BC. Dacryocystorhinostomy. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 7, 2023.\u003c/li\u003e\n\u003cli\u003eShen, X., Huang, C., Wang, S., \u0026amp; Wen, J. (2024). Optimisation of reduction for prolapsed silicone tube after lacrimal intubation. The Journal of laryngology and otology, 138(5), 535\u0026ndash;539. https://doi.org/10.1017/S0022215123001706. \u003c/li\u003e\n\u003cli\u003eLi, M., Li, W., Sha, Q., Yu, L., \u0026amp; Wang, X. (2024). Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis. Medicine, 103(3), e36934. https://doi.org/10.1097/MD.0000000000036934. \u003c/li\u003e\n\u003cli\u003eAli, M. J., Psaltis, A. J., \u0026amp; Wormald, P. J. (2014). Dacryocystorhinostomy ostium: parameters to evaluate and DCR ostium scoring. Clinical ophthalmology (Auckland, N.Z.), 8, 2491\u0026ndash;2499. https://doi.org/10.2147/OPTH.S73998. \u003c/li\u003e\n\u003cli\u003eTadke, K., Lahane, V., \u0026amp; Lokhande, P. (2022). Ostium Characteristics and Its Relevance in Successful Outcome Following Endoscopic Dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 2), 900\u0026ndash;910. https://doi.org/10.1007/s12070-020-01970-2.\u003c/li\u003e\n\u003cli\u003eAl Huthail, R. R., \u0026amp; Al-Faky, Y. H. (2021). Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy. European journal of ophthalmology, 31(6), 3425\u0026ndash;3429. https://doi.org/10.1177/1120672120976044. \u003c/li\u003e\n\u003cli\u003eLIU Nan, PANG Mingjie. Review of factors influencing the prognosis of endoscopic dacryocystorhinostomy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 149-155.\u003c/li\u003e\n\u003cli\u003eShin, H. Y., Paik, J. S., \u0026amp; Yang, S. W. (2018). Clinical Results of Anti-adhesion Adjuvants after Endonasal Dacryocystorhinostomy. Korean journal of ophthalmology : KJO, 32(6), 433\u0026ndash;437. https://doi.org/10.3341/kjo.2017.0124. \u003c/li\u003e\n\u003cli\u003eTadke, K., Lahane, V., \u0026amp; Lokhande, P. (2022). Ostium Characteristics and Its Relevance in Successful Outcome Following Endoscopic Dacryocystorhinostomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 2), 900\u0026ndash;910. https://doi.org/10.1007/s12070-020-01970-2.\u003c/li\u003e\n\u003cli\u003eSoriano, L. M., Damasceno, N. A., Herzog Neto, G., \u0026amp; Damasceno, E. F. (2019). Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy. Clinical ophthalmology (Auckland, N.Z.), 13, 1267\u0026ndash;1271. https://doi.org/10.2147/OPTH.S200923. \u003c/li\u003e\n\u003cli\u003eEvereklioglu C. (2020). Primary Probing with and without Monoka Silastic Stent Intubation for Epiphora in Older Children and Adults. Current eye research, 45(1), 87\u0026ndash;90. https://doi.org/10.1080/02713683.2019.1643026. \u003c/li\u003e\n\u003cli\u003eOrsolini, M. J., Schellini, S. A., Souza Meneguim, R. L. F., \u0026amp; Cat\u0026acirc;neo, A. J. M. (2020). Success of endoscopic dacryocystorhinostomy with or without stents: systematic review and meta-analysis. Orbit (Amsterdam, Netherlands), 39(4), 258\u0026ndash;265. https://doi.org/10.1080/01676830.2019.1677726. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Endoscopic dacryocystorhinostomy, Chronic dacryocystitis, Postoperative personal care","lastPublishedDoi":"10.21203/rs.3.rs-5858763/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5858763/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose: \u003c/strong\u003eTo investigate the impact of early postoperative personal care of endoscopic dacryocystorhinostomy (En-DCR) on surgical outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis prospective study evaluated the early prognosis (1 month) and personal care of 90 patients with 94 eyes who underwent endoscopic dacryocystorhinostomy (En-DCR) for Chronic dacryocystitis（CD）. Surgical outcomes were divided into ostium grade and operative effect. Operative effect was judged by subjective symptom improvement, in addition to ostium assessment based on the results of nasal endoscopic review, and the relationship between operative effect and ostium grade was explored. In addition, we analyzed the key factors affecting operative effect and ostium grade during postoperative personal care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results of correlation analysis between operative effect and objective indicators showed that the outcomes of lacrimal duct irrigation（r=0.444，P＜0.001）, DDT（r=0.217，P=0.036）, and ostium grade（r=0.350，P＜0.001） were positively correlated with the operative effect of patients. The analysis of influencing factors during postoperative nursing showed that patients with nasal saline rinsing at least once a day after operation, nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day after operation and without postoperative respiratory tract infection had better ostium grades and operative effect (P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eThe early surgical outcome of endoscopic dacryocystorhinostomy (En-DCR) is closely related to the condition of the ostium. During postoperative personal care, patients who maintain nasal saline rinsing and nasal spray (Xylometazoline Hydrochloride and Budesonide) at least once a day and reasonably prevent respiratory tract infection tend to have better recovery of early postoperative ostium and better operative effect. Medical staff should strengthen the home nursing guidance for patients after En-DCR day surgery.\u003c/p\u003e","manuscriptTitle":"Analysis of the influence of postoperative personal care on the surgical outcomes of endoscopic dacryocystorhinostomy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-03 08:47:06","doi":"10.21203/rs.3.rs-5858763/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-14T03:38:46+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-10T08:39:27+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-03T16:19:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"71936114727620126460989916530378727406","date":"2025-01-31T11:56:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"10240113374586123586482589658110866351","date":"2025-01-30T13:57:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"223823753384350820019093959600336062172","date":"2025-01-29T12:43:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-29T12:33:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-01-21T11:58:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-01-21T11:11:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Ophthalmology","date":"2025-01-19T09:43:01+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-ophthalmology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"inte","sideBox":"Learn more about [International Ophthalmology](https://www.springer.com/journal/10792)","snPcode":"10792","submissionUrl":"https://submission.nature.com/new-submission/10792/3","title":"International Ophthalmology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"9af7c8ef-c218-41ac-a44b-1bc26aa42847","owner":[],"postedDate":"February 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-03-06T05:53:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-03 08:47:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5858763","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5858763","identity":"rs-5858763","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}