吸烟增加阑尾炎患者阑尾穿孔危险
2009/02/02
在一项瑞典的研究报道中，提示急性阑尾炎患者阑尾穿孔与其现时吸烟相关。另外，肥胖和现时吸烟增加未穿孔阑尾炎患者总术后并发症的危险。
该研究纳入6676例在1971～2004年期间因急性阑尾炎接受开腹阑尾切除术的男性患者。评估吸烟和体块指数(BMI)对纳入者阑尾穿孔危险和术后并发症的影响。
结果显示，在校正了年龄、日历期和BMI等因素后，吸烟显著增加阑尾穿孔的危险[P=0.004,>10包·年现时吸烟者相对危险度（RR） 为1.29]。未穿孔阑尾炎患者的总术后并发症发生率与BMI和现时吸烟显著相关（RR分别为2.50与1.50）。因此，吸烟可以增加阑尾炎患者阑尾穿孔的危险。
（心泉）
附文献:
Br J Surg. 2008 Jun;95(6):751-757.
Br J Surg. 2008 Jun;95(6):751-757.
Impact of body mass index and tobacco smoking on outcome after open appendicectomy.
Sadr Azodi O， Lindström D, Adami J, Bellocco R, Linder S, Wladis A.
Department of Medicine, Clinical Epidemiology Unit, Karolinska University Hospital Solna, Stockholm, Sweden. sayed-omid.sadrazodi@ki.se sayed-omid.sadrazodi@ki.se
BACKGROUND: The effect of body mass index (BMI) and smoking on the risk of perforated appendix and postoperative complications in patients undergoing open appendicectomy for acute appendicitis was studied.
METHODS: Record linkage was used to identify 6676 male construction workers who underwent open appendicectomy for acute appendicitis between 1971 and 2004. Multivariable binomial logistic regression analyses were performed.
RESULTS: After adjustment for age, calendar period and BMI, smoking was significantly associated with an increased risk of perforated appendicitis (PA) (P = 0.004). The relative risk was 1.29 (95 per cent confidence interval 1.11 to 1.50) among current smokers with more than 10 pack-years of tobacco use. In patients with non-perforated appendicitis (NPA), the relative risk of overall postoperative complications was significantly associated with BMI (P < 0.001), and was 2.60 (1.71 to 3.95) in obese patients and 1.51 (1.03 to 2.22) in current smokers with more than 10 pack-years of tobacco use. In patients with PA, overweight, obesity and smoking status were not associated with an increased risk of overall postoperative complications.
CONCLUSION: Perforation due to acute appendicitis was associated with current tobacco smoking. A BMI of 27.5 kg/m(2) or more and current smoking were associated with overall postoperative complications in patients with NPA. 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
METHODS: Record linkage was used to identify 6676 male construction workers who underwent open appendicectomy for acute appendicitis between 1971 and 2004. Multivariable binomial logistic regression analyses were performed.
RESULTS: After adjustment for age, calendar period and BMI, smoking was significantly associated with an increased risk of perforated appendicitis (PA) (P = 0.004). The relative risk was 1.29 (95 per cent confidence interval 1.11 to 1.50) among current smokers with more than 10 pack-years of tobacco use. In patients with non-perforated appendicitis (NPA), the relative risk of overall postoperative complications was significantly associated with BMI (P < 0.001), and was 2.60 (1.71 to 3.95) in obese patients and 1.51 (1.03 to 2.22) in current smokers with more than 10 pack-years of tobacco use. In patients with PA, overweight, obesity and smoking status were not associated with an increased risk of overall postoperative complications.
CONCLUSION: Perforation due to acute appendicitis was associated with current tobacco smoking. A BMI of 27.5 kg/m(2) or more and current smoking were associated with overall postoperative complications in patients with NPA. 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
PMID: 18418861 [PubMed - indexed for MEDLINE]
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