【摘要】 目的 :探讨吸烟与腰椎间盘突出症手术预后关系。方法 :研究对象为住院行腰椎间盘突出症手术治疗患者共计 3 2 1名 ,患者术前记录吸烟量 ,按吸烟量分为 3组 :正常组、轻度吸烟组和重度吸烟组。同时记录自我评定抑郁量表(SDS)评分 ,术前腰腿痛程度 (VAS)。疗效评价标准根据北美脊柱协会制定的 60项指标结合临床实际制定出评价量表。结果 :术前疼痛评分 ,SDS评分 ,术后改善率重度吸烟组和轻度吸烟组明显高于不吸烟组 (P <0 .0 5或P <0 .0 1) ,说明吸烟者术前更加疼痛 ,抑郁发生率较高 ,术后改善率差。重度吸烟组和轻度吸烟组的SDS评分、术后改善率比较有统计学差异 (P <0 .0 5或P <0 .0 1) ,而术前疼痛评分无明显统计学差异。正常组与抑郁组之间术前疼痛和改善率有统计学差异 (P <0 .0 5或P <0 .0 1) ,说明抑郁患者术前有更明显的疼痛和较差术后改善率。吸烟者更易患抑郁症即吸烟是抑郁的危险因素 ,相对危险度OR =1.889( 95 %CI 1.165～ 3 .0 63 )。结论 :吸烟是腰椎间盘手术的不利因素 ,吸烟与抑郁之间有相关性。吸烟可以导致一个较差的手术效果 ,因此减少或停止吸烟可能增加手术的改善率。更多还原

【Abstract】 Objective: To determine the prognostic correlation of surgical outcomes and smoking in patients with lumbar disc herniation. Methods: The study population was a consecutive series of 321 patients undergone the operation therapy of lumbar disc herniation in the hospital. The number of cigarette smoked per day, number of years of smoking and point of SDS of each patient were recorded before operations. The patients were separated into 3 groups based on the quantity of smoking. The criteria for the evaluation of outcomes was the questionnaire of outcome assessment score which was devised according to the 60 criteria established by North American Spine Society and our clinical experience. The questionnaire was scored using a graded point scale before surgery and the same one was used at the follow up. Results: The point of pre surgical pain, the point of SDS and remission rate of the nonsmoker group was more significant than that of the light smoker (<100 cigarettes a month) and heavy smoker (>100 cigarettes a month) ( P<0.05 or P<0.01 ). The point of SDS and remission rate of the light smoker was more significant than that of heavy smoker ( P<0.05 or P<0.01 ). No statistic difference existed in the point of pre surgical pain between the light smoker and heavy smoker groups. The point of pre surgical pain and remission rate of the normal group was more significant than that of the depression group ( P<0.05 or P<0.01 ). Smoker were likely to report symptoms depression (odds ratio, 1.889; 95% confidence interval 1.165～3.063). Conclusion: The smoking is disadvantageous factor for surgical therapy in patients with lumbar disc herniation. Ex smoking may be important for the rehabilitation after surgery.更多还原