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囊性纤维化患儿行鼻内镜鼻窦手术的安全性

Safety of endoscopic sinus surgery in children with cystic fibrosis.

作者信息

Tumin Dmitry, Hayes Don, Kirkby Stephen E, Tobias Joseph D, McKee Christopher

机构信息

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, United States.

Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, OH 43205, United States; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, United States.

出版信息

Int J Pediatr Otorhinolaryngol. 2017 Jul;98:25-28. doi: 10.1016/j.ijporl.2017.04.034. Epub 2017 Apr 24.

Abstract

INTRODUCTION

Data on the safety of endoscopic sinus surgery (ESS) are limited in children with cystic fibrosis (CF). We used a multi-institutional surgical registry to examine ESS outcomes in children with CF.

METHODS

The 2014-2015 American College of Surgeons' National Surgical Quality Improvement Program-Pediatric database was queried for patients age <18 years undergoing elective ESS. Prolonged hospital stay (>1 day), 30-day readmission, and 30-day unplanned reoperation were compared according to presence of CF diagnosis.

RESULTS

The data included 213 children with CF (age 10 ± 5 years, 105/108 male/female) and 821 children without CF (age 10 ± 5 years, 504/317 male/female). CF patients were more likely than non-CF patients to require prolonged hospital stay (30% vs. 9%, p < 0.001), yet had similar rates of readmission (6% vs. 4%; p = 0.189) and reoperation (0 vs. 1%; p = 0.133). All readmissions but one among CF patients were unrelated to ESS. In the non-CF cohort, reasons for ESS-related readmissions included recurrence of sinusitis, postoperative pain, and bleeding.

CONCLUSIONS

We demonstrate the safety of ESS in the largest cohort of children with CF reviewed to date. Multi-institutional review of ESS safety may contribute to monitoring expansion of this intervention in children with CF.

摘要

引言

关于囊性纤维化(CF)患儿内镜鼻窦手术(ESS)安全性的数据有限。我们使用了一个多机构手术登记系统来研究CF患儿的ESS手术结果。

方法

查询2014 - 2015年美国外科医师学会国家外科质量改进计划 - 儿科数据库,以获取年龄小于18岁接受择期ESS手术的患者信息。根据是否存在CF诊断,比较延长住院时间(>1天)、30天再入院率和30天非计划再次手术率。

结果

数据包括213名CF患儿(年龄10±5岁,男105例/女108例)和821名非CF患儿(年龄10±5岁,男504例/女317例)。CF患者比非CF患者更有可能需要延长住院时间(30%对9%,p<0.001),但再入院率(6%对4%;p = 0.189)和再次手术率(0对1%;p = 0.133)相似。CF患者中除1例之外的所有再入院情况均与ESS无关。在非CF队列中,ESS相关再入院的原因包括鼻窦炎复发、术后疼痛和出血。

结论

我们证明了ESS在迄今为止所审查的最大规模CF患儿队列中的安全性。对ESS安全性的多机构审查可能有助于监测该干预措施在CF患儿中的推广应用。

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