尼氏胃底折叠术后儿童短期和长期抗反流及哮喘药物的使用情况

Short- and long-term antireflux and asthma medication use in children after nissen fundoplication.

作者信息

Lee Steven L

出版信息

Perm J. 2009 Spring;13(2):4-11. doi: 10.7812/TPP/08-061.

DOI:10.7812/TPP/08-061

PMID:21373224

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3034429/

Abstract

PURPOSE

We sought to determine antireflux and asthma medication use after Nissen fundoplication (NF).

METHODS

We performed a retrospective study using hospital discharge and pharmacy data from 1996 through 2005. A total of 342 pediatric patients had ≥1 NF; 336 of those had complete medication data. Use of antireflux medications and asthma medications were reviewed before and after NF.

RESULTS

Short-term (one year after NF) use of antireflux medications decreased (odds ratio [OR] = 0.35; 95% confidence interval [CI], 0.26-0.45). During the entire study period, the decrease in antireflux medication use after NF remained in place (233 to 197 patients; OR = 0.63; 95% CI, 0.47-0.84). Use of antireflux medications decreased in neurologically healthy patients (n = 186) after NF but remained the same in neurologically impaired patients. Short-term use of inhaled and systemic asthma medications did not change (OR = 1.16 [95% CI, 0.89-1.51] and 0.90 [95% CI, 0.69-1.18]), respectively. During the entire study period, inhaled and systemic asthma medication use increased after NF (OR = 2.11 [95% CI, 1.63-2.74] and 1.85 [95% CI, 1.43-2.41]), respectively. Inhaled and systemic asthma medication use increased in both neurologically healthy and impaired children. In older children (age >5 years), short-term use of inhaled and systemic asthma medications decreased after NF (OR = 0.39 [95% CI, 0.25-0.60] and 0.31 [95% CI, 0.19-0.53]), respectively. However, during the entire study period, inhaled and systemic asthma medication use in older children remained the same.

CONCLUSION

NF decreased antireflux medication use in the short and long term, particularly in neurologically healthy children. Inhaled and systemic asthma medication use increased after NF in neurologically healthy and impaired children. NF provided a short-term decrease in inhaled and systemic asthma medication use in older children but showed no change in the long term.

摘要

目的

我们试图确定nissen胃底折叠术（NF）后抗反流和哮喘药物的使用情况。

方法

我们利用1996年至2005年的医院出院和药房数据进行了一项回顾性研究。共有342名儿科患者接受了≥1次NF手术；其中336名患者有完整的用药数据。对NF前后抗反流药物和哮喘药物的使用情况进行了评估。

结果

NF术后短期（术后一年）抗反流药物的使用减少（优势比[OR]=0.35；95%置信区间[CI]，0.26-0.45）。在整个研究期间，NF术后抗反流药物的使用持续减少（从233例患者降至197例；OR=0.63；95%CI，0.47-0.84）。NF术后神经功能正常的患者（n=186）抗反流药物的使用减少，但神经功能受损的患者则保持不变。吸入性和全身性哮喘药物的短期使用没有变化（OR分别为1.16[95%CI，0.89-1.51]和0.90[95%CI，0.69-1.18]）。在整个研究期间，NF术后吸入性和全身性哮喘药物的使用增加（OR分别为2.11[95%CI，1.63-2.74]和1.85[95%CI，1.43-2.41]）。神经功能正常和受损的儿童吸入性和全身性哮喘药物的使用均增加。在年龄较大的儿童（年龄>5岁）中，NF术后吸入性和全身性哮喘药物的短期使用减少（OR分别为0.39[95%CI，0.25-0.60]和0.31[95%CI，0.19-0.53]）。然而，在整个研究期间，年龄较大儿童吸入性和全身性哮喘药物的使用保持不变。