McMurphy Andrea Barber, Morriss Craig, Roberts Dianna B, Friedman Ellen M
96th Surgical Operations Squadron/SGCXL, Eglin Air Force Base, Florida, USA.
Am J Rhinol. 2007 Nov-Dec;21(6):706-10. doi: 10.2500/ajr.2007.21.3104.
This study was performed to evaluate the usefulness of computed tomography (CT) scans of the sinuses in children with cystic fibrosis (CF) as an outcomes measurement for medical and surgically treated chronic rhinosinusitis.
Patients with CF who had sinus scans performed at the study institution from January 1999 to September 2003 were identified. The scans and any available prior scans were scored according to the Lund-MacKay system. A retrospective chart review determined if hospitalization with i.v. antibiotic therapy or operative intervention had occurred between scans and if the scans showed improvement secondary to the intervention.
One hundred thirty-four patients were identified who met inclusion criteria. A total of 290 scans were reviewed, with the average number of CT scans per patient of 2.24 (range, 1-10). The average Lund-MacKay score for scans closest in time to the first sinus surgery was 14.5. (range, 7-24), and for the first postoperative scans, the score was 14.7 (8-24). There was no significant difference between the preoperative and postoperative Lund-MacKay score after initial surgery (p = 0.99) or in subsequent scans despite medical or surgical interventions (p = 0.90).
CT scanning of the sinuses does not appear to be useful in determining outcomes of intervention in CF patients.
本研究旨在评估鼻窦计算机断层扫描(CT)在囊性纤维化(CF)患儿中作为药物和手术治疗慢性鼻窦炎疗效评估指标的实用性。
确定1999年1月至2003年9月在研究机构进行鼻窦扫描的CF患者。根据Lund-MacKay系统对扫描结果及任何可用的既往扫描结果进行评分。回顾性病历审查确定在两次扫描之间是否发生了静脉注射抗生素治疗或手术干预住院,以及扫描结果是否显示干预后有所改善。
确定了134名符合纳入标准的患者。共审查了290次扫描,每位患者的CT扫描平均次数为2.24次(范围为1 - 10次)。与首次鼻窦手术时间最接近的扫描的平均Lund-MacKay评分为14.5(范围为7 - 24),首次术后扫描的评分为14.7(8 - 24)。初次手术后术前和术后Lund-MacKay评分之间无显著差异(p = 0.99),在后续扫描中,无论采用药物或手术干预,评分也无显著差异(p = 0.90)。
鼻窦CT扫描似乎对确定CF患者的干预效果无用。