University of Kansas School of Medicine, Kansas City, Kansas, USA.
Laryngoscope. 2014 Apr;124(4):1000-7. doi: 10.1002/lary.24224. Epub 2013 Dec 6.
OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis(CRS) results in significant morbidity and health care expenditure. Safety and efficacy of nasal irrigation use in the treatment of pediatric CRS have been demonstrated, but long-term outcomes are unknown. We reviewed characteristics and treatment outcomes after 6 weeks of once daily nasal irrigation in pediatric CRS based on computed tomography (CT) scans, and summarized parental reports of subsequent use of nasal irrigation for recurring symptoms
Retrospective cohort study and cross-sectional survey.
Review and survey of 144 pediatric CRS patients diagnosed between July 2003 and January 2012.
One hundred four patients were reviewed. Mean age was 8.0 years, and 65.4% were male. Presenting symptoms included congestion (95.2%), cough (79.8%), rhinorrhea (60.6%), headache (48.1%), and fatigue (40.4%). Comorbidities included positive allergy test (50%), asthma (57.3%), and gastroesophageal reflux disease (28.2%). After 6 weeks, 57.7% of patients reported complete resolution of symptoms. Reductions in Lund-Mackay CT scores were 4.14 and 4.38 on the left and right sides, respectively (P < .001). Of the 54 parents who completed the prospective surveys, 53.7% reported using irrigation again in the past 12 months (median = 1, interquartile range = 3). Only nine patients underwent functional endoscopic sinus surgery (FESS) after the initial 6 weeks. Patients requiring FESS were, on average, 3.6 years older than those who did not receive FESS (P = 0.0005). Median length of follow-up was 48 months (range = 20-113). There were no significant differences in age, Lund-MacKay score changes, and symptom resolution proportions between those who completed the survey and those who did not.
Nasal irrigation is effective as a first-line treatment for pediatric CRS and subsequent nasal symptoms, and reduces the need for FESS and CT imaging.
2b.
目的/假设：慢性鼻-鼻窦炎（CRS）会导致显著的发病率和医疗保健支出。已经证明鼻腔冲洗在治疗小儿 CRS 中的安全性和有效性，但长期结果尚不清楚。我们根据计算机断层扫描（CT）扫描回顾了小儿 CRS 患者在接受每日一次鼻腔冲洗治疗 6 周后的特征和治疗结果，并总结了父母报告的后续使用鼻腔冲洗治疗反复发作症状的情况。
回顾性队列研究和横断面调查。
回顾和调查 2003 年 7 月至 2012 年 1 月期间诊断的 144 例小儿 CRS 患者。
对 104 例患者进行了回顾。平均年龄为 8.0 岁，65.4%为男性。主要症状包括鼻塞（95.2%）、咳嗽（79.8%）、流涕（60.6%）、头痛（48.1%）和疲劳（40.4%）。合并症包括过敏测试阳性（50%）、哮喘（57.3%）和胃食管反流病（28.2%）。6 周后，57.7%的患者报告症状完全缓解。左侧和右侧的 Lund-Mackay CT 评分分别降低了 4.14 和 4.38（P<0.001）。在完成前瞻性调查的 54 位家长中，53.7%报告在过去 12 个月内再次使用冲洗（中位数=1，四分位距=3）。初始 6 周后仅有 9 例患者接受了功能性内镜鼻窦手术（FESS）。需要 FESS 的患者平均年龄比不需要 FESS 的患者大 3.6 岁（P=0.0005）。中位随访时间为 48 个月（范围 20-113）。在完成调查和未完成调查的患者之间，年龄、Lund-MacKay 评分变化和症状缓解比例均无显著差异。
鼻腔冲洗作为小儿 CRS 及随后鼻腔症状的一线治疗方法是有效的，并减少了 FESS 和 CT 成像的需求。
2b。
