缺血性脑卒中和短暂脑缺血发作后戒烟干预:随机对照预试验
2012/01/31
摘要
背景:戒烟被广泛用于预防继发性卒中。然而,有关中风或短暂脑缺血发作(TIA)后戒烟干预措施的效果尚不清楚。
方法:94名年龄小于76岁的吸烟者,因缺血性脑卒中或TIA而入院治疗,随机分组后接受最小化戒烟干预和集中戒烟干预。所有患者接受由本研究护士提供的为期30分钟的个性化咨询。集中戒烟干预组患者同时参与5次由官方戒烟指导者组织的门诊戒烟项目、6周后进行的一次30分钟的门诊随访和本研究护士进行的5次电话随访。免费给集中干预组患者提供尼古丁替代治疗。6个月后,通过自我主诉和检测呼出气一氧化碳水平,确定是否戒烟。参与的患者数比预期少,因此,本试验仅为预实验。
结果:6个月后,自我主诉的戒断率,在最小化干预组为37.8%,集中干预组为42.9%。由检测呼吸气一氧化碳含量确认的戒断率,在最小化干预组为28.9%,集中干预组为32.7%。两组之间未见显著差异(χ2 = 0.16, p =0.69)。
结论:总体戒烟率成中等水平,与其他研究结果相当。集中戒烟干预并不优于短期戒烟干预。因此,除了戒烟强度之外,可能还有其他因素影响患者卒中或TIA后戒烟。
(陈欣 审校)
Nicotine Tob Res. 2011 Dec 21. [Epub ahead of print]
Smoking Cessation Intervention After Ischemic Stroke or Transient Ischemic Attack. A Randomized Controlled Pilot Trial.
Brunner Frandsen N, Sørensen M, Hyldahl TK, Henriksen RM, Bak S.
Source
Corresponding Author: N. Brunner Frandsen, M.D., Department of Neurology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Telephone: +45-65-41-24-75; Fax: +45-65-41-33-89; E-mail: nbrunner80@hotmail.com.
Abstract
BACKGROUND: Smoking cessation is widely recommended for secondary stroke prevention. However, little is known about the efficacy of smoking cessation intervention after stroke or transient ischemic attack (TIA).
METHODS: Ninety-four smokers under age 76, admitted with ischemic stroke or TIA were randomized to minimal smoking cessation intervention or intensive smoking cessation intervention. All patients attended a 30-min individual counseling by the study nurse. Patients randomized to intensive smoking cessation intervention also participated in a 5-session outpatient smoking cessation program by an authorized smoking cessation instructor, a 30-min outpatient visit after 6 weeks, and 5 telephone counseling sessions by the study nurse. Free samples of nicotine replacement therapy were offered as part of the intensive smoking cessation program. Smoking cessation rates at 6 months were determined by self-report and verified by measurement of exhaled carbon monoxide (CO). Fewer patients than expected were recruited, which renders this report a pilot study.
RESULTS: The 6-month self-reported smoking cessation rate was 37.8% in the minimal intervention group and 42.9% in the intensive intervention group. Smoking cessation rates verified by exhaled CO levels in the minimal intervention group and the intensive intervention group were 28.9% and 32.7%, respectively. No difference was found between the two groups (χ(2) = 0.16, p = .69).
CONCLUSIONS: Overall smoking cessation rates were moderate and comparable to the results from other studies. Intensive smoking cessation intervention was not superior to short smoking cessation intervention. Thus, other factors than intensity of smoking cessation intervention might influence the smoking cessation rates after stroke or TIA.
Nicotine Tob Res. 2011 Dec 21. [Epub ahead of print]
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妊娠期同伴支持戒烟:系统综述
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