内镜鼻窦手术对 DeltaF508 囊性纤维化患者临床结局的影响。
Effect of endoscopic sinus surgery on clinical outcomes in DeltaF508 cystic fibrosis patients.
机构信息
St. Paul's Sinus Centre, Division of Otolaryngology, University of British Columbia, Vancouver, BC, Canada.
Adult Cystic Fibrosis Clinic, University of British Columbia, Vancouver, BC, Canada.
出版信息
Clin Otolaryngol. 2021 Sep;46(5):941-947. doi: 10.1111/coa.13751. Epub 2021 Mar 13.
OBJECTIVES
Chronic rhinosinusitis (CRS) is prevalent in the Cystic Fibrosis (CF) population. CRS exacerbations in CF are thought to contribute to pulmonary exacerbations. Literature regarding the impact of endoscopic sinus surgery (ESS) is inconclusive. This study examines rates of lung function decline and pulmonary exacerbation in CF patients who have undergone ESS.
DESIGN
Retrospective review of medical records.
SETTING
Academic Hospital.
PARTICIPANTS
40 adult CF patients.
MAIN OUTCOME MEASURES
Rate of lung function decline (% predicted Forced Expiratory Volume in 1 second [ppFEV ]), number of pulmonary exacerbations (IV/oral antibiotic therapy ± hospital admission) and total number days hospitalised 2-year postoperatively was collected. CRS patients undergoing ESS were matched to those without ESS by gender, age, and F508del genotype.
RESULTS
Forty patients (mean age 37.4, 60% male) were reviewed. No significant difference was found between the surgical group and controls in baseline ppFEV (72.5% vs. 72.7%, P = .98), 2-year preoperative number of pulmonary exacerbations (3.05 vs. 1.65, P = .10), or Lund-Mackay scores (12.25 vs. 11.55, P = .71). No significant difference was found in 1-year (70.5% vs. 72.8%, P = .84) or 2-year (70.4% vs. 72.6% P = .80) postoperative ppFEV and 2-year postoperative pulmonary exacerbations (1.7 vs. 1.45, P = .87). A significant increase was identified in total number days hospitalised postoperatively (4.85, P = .02). In the surgical group, no significant difference was identified between preoperative and postoperative ppFEV , 1 year (-2.51%, P = .32) and 2 years after ESS (-3.10%, P = .51), postoperative rate of pulmonary exacerbations (-1.28, P = .11), or in total number days hospitalised (3.74, P = .14).
CONCLUSIONS
In this study, ESS does not appear to significantly improve ppFEV or decrease the number of pulmonary exacerbations postoperatively.
目的
慢性鼻-鼻窦炎（CRS）在囊性纤维化（CF）人群中较为普遍。CF 患者的 CRS 恶化被认为会导致肺部恶化。关于内镜鼻窦手术（ESS）的影响的文献尚无定论。本研究旨在研究接受 ESS 的 CF 患者的肺功能下降和肺部恶化的发生率。
设计
病历回顾性研究。
地点
学术医院。
参与者
40 名成年 CF 患者。
主要观察指标
术后 2 年内的肺功能下降率（预计用力呼气量的百分比[ppFEV]）、肺部恶化次数（静脉/口服抗生素治疗±住院）和总住院天数。通过性别、年龄和 F508del 基因型，将接受 ESS 的 CRS 患者与未接受 ESS 的患者进行匹配。
结果
共回顾了 40 名患者（平均年龄 37.4 岁，60%为男性）。手术组和对照组在基线时的 ppFEV（72.5%与 72.7%，P=0.98）、术前 2 年的肺部恶化次数（3.05 与 1.65，P=0.10）或 Lund-Mackay 评分（12.25 与 11.55，P=0.71）方面均无显著差异。术后 1 年（70.5%与 72.8%，P=0.84）和 2 年（70.4%与 72.6%，P=0.80）的 ppFEV 以及术后 2 年的肺部恶化次数（1.7 与 1.45，P=0.87）均无显著差异。术后总住院天数显著增加（4.85，P=0.02）。在手术组中，术前和术后的 ppFEV 均无显著差异，术后 1 年（-2.51%，P=0.32）和 2 年（-3.10%，P=0.51），术后肺部恶化率（-1.28%，P=0.11）或总住院天数（3.74，P=0.14）均无显著差异。
结论
在这项研究中，ESS 似乎并没有显著改善术后的 ppFEV 或减少肺部恶化的次数。
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