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首页> 外文期刊>Allergy >Negative impact of occupational exposure on surgical outcome in patients with rhinosinusitis
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Negative impact of occupational exposure on surgical outcome in patients with rhinosinusitis

机译：职业暴露对鼻-鼻窦炎患者手术效果的负面影响

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Background Chronic rhinosinusitis (CRS) is a frequent condition that is treated by functional endoscopic sinus surgery (FESS) when medical treatment fails. Endogenous as well as exogenous factors may be responsible for persisting symptoms after FESS. The role of occupational exposures on success of FESS has never been investigated. Methods In this case-control study, we tested the hypothesis that the outcome of FESS procedures is related to exposures at work. Questionnaires were sent to 890 patients who had undergone one or more FESS procedures and to 182 controls. Three independent experts assessed blindly the reported work exposures to inhaled agents. The relationship between exposure and the number of FESS procedures was analyzed. Results Relevant occupational exposure was reported by 25% of all responding patients undergoing FESS (n = 467) and 12% of controls (n = 69). The prevalence of occupational exposures increased linearly with the number of FESS procedures from 21% in those who had one FESS to 44% in those who had four or more FESS (χ 2 = 12.74, P 0.001). Logistic regression analysis with adjustments for potential confounders, including smoking, atopy, and asthma, confirmed that the odds ratio (OR) for reporting occupational exposures was significantly higher in those needing more than one FESS (OR = 1.64) or more than two FESS (OR = 1.97). These results were mainly driven by exposure to low molecular weight agents. Conclusion Exposure at work appears to be a risk factor for the occurrence of CRS and for its recurrence or persistence, as evidenced by the need for revision surgery.
机译：背景慢性鼻鼻窦炎（CRS）是一种常见病，当药物治疗失败时，可通过功能性内窥镜鼻窦手术（FESS）进行治疗。内源性和外源性因素可能是FESS后症状持续的原因。从未研究过职业暴露对FESS成功的作用。方法在本病例对照研究中，我们检验了以下假设：FESS程序的结果与工作中的暴露有关。将问卷调查表发送给890例接受了一项或多项FESS程序的患者以及182例对照。三名独立专家盲目评估了所报告的吸入剂暴露情况。分析了暴露与FESS程序数量之间的关系。结果据报告，所有接受FESS治疗的缓解患者中有25％（n = 467）和对照组的12％（n = 69）有相关的职业暴露。职业暴露的患病率随着FESS程序次数的增加而线性增加，从一次FESS者的21％上升到四个FESS或更多者的44％（χ2 = 12.74，P <0.001）。通过对包括吸烟，特应性疾病和哮喘在内的潜在混杂因素进行调整的Logistic回归分析证实，报告职业暴露的比值比（OR）在需要超过一个FESS（OR = 1.64）或两个以上FESS（ OR = 1.97）。这些结果主要是由接触低分子量试剂引起的。结论工作中的暴露似乎是CRS发生，复发或持续的危险因素，这需要进行翻修手术。

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