Oswaldo A Henriquez, Lindy L Wolfenden, Arlene Stecenko, John M Delgaudio, Sarah K Wise
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No significant differences were found between mean preoperative and postoperative FEV1 (61.3% vs 59.5%; P = .41) or FVC (76.4% vs 76.1%; P = .97) or between best preoperative and postoperative FEV1 (67.4% vs 67.0%; P = .95) or FVC (84.2% vs 83.0%; P = .86) (paired samples t test). The number of IV antibiotic courses and the total number of days of IV antibiotic use did not differ between the preoperative and postoperative periods (Wilcoxon signed rank test P = .61 and P = .10, respectively). However, the number of IHDs was significantly lower in the 1-year postoperative period (36.7 days) vs the 1-year preoperative period (59.1 days) (Wilcoxon signed rank test, z = -2.20, P = .03).</p><p><strong>Conclusions: </strong>This preliminary study of ESS in adult CF patients indicates significant reduction in the number of IHDs in the postoperative period. 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引用次数: 21
摘要
目的:探讨内镜鼻窦手术(ESS)对成人囊性纤维化(CF)患者肺功能、静脉(IV)抗生素使用及住院治疗的影响。设计:回顾性分析。设置:三级保健中心。患者:2006年3月1日至2008年6月31日期间,15名诊断为CF的成年人接受ESS治疗。主要观察指标:评估术前和术后12个月肺功能(用力肺活量(FVC)和用力肺活量(FEV1))、静脉抗生素疗程数、静脉抗生素总使用天数、住院天数(IHDs)。结果:22例CF患者接受了ESS治疗;15例患者有足够的资料进行评估。术前和术后平均FEV1无显著差异(61.3% vs 59.5%;P = 0.41)或FVC (76.4% vs 76.1%;P = 0.97)或术前和术后最佳FEV1之间(67.4% vs 67.0%;P = 0.95)或FVC (84.2% vs 83.0%;P = .86)(配对样本t检验)。静脉抗生素疗程数和静脉抗生素使用总天数在术前和术后无显著差异(Wilcoxon符号秩检验P = 0.61和P = 0.10)。然而,ihd数量在术后1年(36.7天)明显低于术前1年(59.1天)(Wilcoxon sign rank检验,z = -2.20, P = .03)。结论:这项对成年CF患者ESS的初步研究表明,术后ihd数量显著减少。然而,没有证据表明ESS能改善肺功能或需要静脉注射抗生素。
Endoscopic sinus surgery in adults with cystic fibrosis: effect on lung function, intravenous antibiotic use, and hospitalization.
Objective: To ascertain the effect of endoscopic sinus surgery (ESS) on lung function, intravenous (IV) antibiotic use, and hospitalization in adults with cystic fibrosis (CF).
Design: Retrospective analysis.
Settings: Tertiary care center.
Patients: Fifteen adults with a diagnosis of CF undergoing ESS between March 1, 2006, and June 31, 2008.
Main outcome measures: Twelve-month preoperative and 12-month postoperative pulmonary function testing (forced vital capacity [FVC] and forced expired volume in 1 second [FEV1]), number of IV antibiotic courses, total number of days of intravenous antibiotic use, and number of inpatient hospital days (IHDs) were assessed.
Results: Twenty-two adults with CF underwent ESS; 15 patients had adequate data for evaluation. No significant differences were found between mean preoperative and postoperative FEV1 (61.3% vs 59.5%; P = .41) or FVC (76.4% vs 76.1%; P = .97) or between best preoperative and postoperative FEV1 (67.4% vs 67.0%; P = .95) or FVC (84.2% vs 83.0%; P = .86) (paired samples t test). The number of IV antibiotic courses and the total number of days of IV antibiotic use did not differ between the preoperative and postoperative periods (Wilcoxon signed rank test P = .61 and P = .10, respectively). However, the number of IHDs was significantly lower in the 1-year postoperative period (36.7 days) vs the 1-year preoperative period (59.1 days) (Wilcoxon signed rank test, z = -2.20, P = .03).
Conclusions: This preliminary study of ESS in adult CF patients indicates significant reduction in the number of IHDs in the postoperative period. However, there is no evidence that ESS improved lung function or the need for IV antibiotics.