MANAGEMENT OF CHRONIC SINUSITIS IN CYSTIC-FIBROSIS
MANAGEMENT OF CHRONIC SINUSITIS IN CYSTIC-FIBROSIS
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DOI：
10.1288/00005537-199504000-00002
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发表时间：
1995-04-01
期刊：
影响因子：
2.6
通讯作者：
LIGHT, M
中科院分区：
文献类型：
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作者：
DAVIDSON, TM;MURPHY, C;LIGHT, M
慢性鼻窦炎在囊性纤维化患者中非常常见。它会给这些患者带来许多问题，并可能使他们面临危及生命的疾病的风险。潜在的问题包括鼻塞，充血，鼻窦疼痛和压力，感染（通常是假单胞菌），嗅觉减退或嗅觉丧失，以及细菌进入下呼吸道。慢性鼻窦感染的囊性纤维化患者在肺移植后发生肺炎的风险增加。一种预防性方案已经开发用于囊性纤维化患者的慢性鼻窦炎的管理。这些患者在加州大学圣地亚哥分校（UCSD）医学中心的鼻功能障碍诊所接受全面评估。根据评估的结果，他们接受了内窥镜鼻窦手术，部分中鼻甲切除术，鼻中隔成形术和一个大的中鼻道上颌窦造口术。手术后进行严格的脉冲式低渗盐水鼻腔冲洗方案，以冲走顽固的囊性分泌物。妥布霉素（Nebcin（R））在鼻腔冲洗液中每日给药一次，以抑制假单胞菌的生长。在USCD鼻功能障碍诊所，这种肺移植前方案现在用于所有慢性鼻窦炎囊性纤维化患者。
Chronic rhinosinusitis is extremely common in patients with cystic fibrosis. It causes numerous problems in these patients and can put them at risk for life-threatening illness. Potential problems include nasal obstruction, congestion, sinus pain and pressure, infection (usually with Pseudomonas organisms), hyposmia or anosmia, and the seeding of bacteria into the lower respiratory tract. Cystic fibrosis patients with chronically infected sinuses are at increased risk for pneumonia following lung transplantation. A prophylactic protocol has been developed for the management of chronic sinusitis in patients with cystic fibrosis. These patients are fully evaluated at the Nasal Dysfunction Clinic of the University of California, San Diego (UCSD), Medical Center. Based on the results of the evaluation, they are treated with endoscopic sinus surgery, partial middle turbinectomy, septoplasty, and a large middle meatal maxillary antrostomy. Surgery is followed by a rigorous regimen of pulsatile hypotonic saline nasal irrigation to wash away tenacious cystic secretions. Tobramycin (Nebcin(R)) is given once daily in the nasal irrigant to inhibit the growth of Pseudomonas organisms. At the USCD Nasal Dysfunction Clinic, this prepulmonary transplantation protocol is now used in all cystic fibrosis patients with chronic sinusitis.