Karner-Hanusch J, Mittlböck M, Salat A, Pichl K, Polterauer P
Klinischen Abteilung für Gefässchirurgie, Universitätsklinik für Chirurgie, Wien.
Wien Med Wochenschr. 1994;144(22-23):561-5.
In a retrospective study of 2,988 patients operated because of chronic occlusive arterial disease preoperative smoking habits were related to the patency rates of arterial reconstructions of carotid arteries, infrarenal aorta, iliac vessels, of the lower extremity, and to overall survival rates: 1) 75.2% of the patients were smokers, 24.8% were nonsmokers (NS). 2) Smokers needed the first vascular procedure about 7 years earlier than NS (62.4 +/- 10.3 vs. 69.9 +/- 9.9 years of age; p = 0.001). 3) A significant difference between the 2 groups could be found regarding the location of occlusion (p = 0.000): 20.7% of all occlusions of infrarenal aorta and iliac vessels occurred in smokers (8.8% NS), whereas NS showed a higher percentage of carotid artery stenosis (20.5 vs. 11.9% in smokers). 4) Postoperative morbidity and mortality did not differ between the 2 groups. There was no difference regarding primary patency rates and preoperative smoking habits. 5) The late patency rates of reconstruction of the legs were 72.4 and 52.9% for smokers 1 and 5 years after operation, which was significantly higher than in NS (65.5 and 46%). 6) The overall number of reoperations was higher in smokers than in NS (p = 0.001). 7) Smokers received significantly less often a further anticoagulant treatment than NS (40 vs. 47%; p < or = 0.05). 8) Preoperative smoking habits influenced the overall survival rate in a statistically significant manner with disadvantage for smokers (74.5 vs. 79.9 years; p = 0.000).
在一项针对2988例因慢性闭塞性动脉疾病接受手术的患者的回顾性研究中，术前吸烟习惯与颈动脉、肾下腹主动脉、髂血管、下肢动脉重建的通畅率以及总生存率相关：1）75.2%的患者为吸烟者，24.8%为非吸烟者（NS）。2）吸烟者比非吸烟者大约早7年需要首次血管手术（年龄分别为62.4±10.3岁和69.9±9.9岁；p = 0.001）。3）两组在闭塞部位方面存在显著差异（p = 0.000）：肾下腹主动脉和髂血管的所有闭塞中有20.7%发生在吸烟者中（非吸烟者为8.8%），而非吸烟者中颈动脉狭窄的比例更高（吸烟者为11.9%，非吸烟者为20.5%）。4）两组术后发病率和死亡率无差异。在原发性通畅率和术前吸烟习惯方面也无差异。5）吸烟者术后1年和5年腿部重建的晚期通畅率分别为72.4%和52.9%，显著高于非吸烟者（分别为65.5%和46%）。6）吸烟者再次手术的总数高于非吸烟者（p = 0.001）。7）吸烟者接受进一步抗凝治疗的频率显著低于非吸烟者（40%对47%；p≤0.05）。8）术前吸烟习惯对总生存率有统计学上的显著影响，对吸烟者不利（分别为74.5岁和79.9岁；p = 0.000）。
