吸烟对再植断指血管危象发生率影响的临床观察

Effect of cigarette smoking on vascular crisis of replanted digit

目的 探讨吸烟对断指再植术后血管危象发生率的影响及机制。方法 观察吸烟后发生血管危象比率;分析血管危象发生时间、处理结果;比较吸烟方式对血管危象发生的影响。结果 吸烟显著增加再植断指血管危象发生率,被动吸烟者超过主动吸烟者;血管危象大多(94.87％)发生在14日内,其中85.33％为动脉危象,6.67％为静脉危象,8.0％为混合危象;血管痉挛因素明显高于血栓因素。结论 吸烟极易诱发血管危象;指动脉顽固性痉挛、血液粘稠度增加是吸烟导致血管危象的主要病理机制。

Objective To analyze the effect of cigarette smoking on incidence of vascular crisis ( VC) of re-planted digits, investigate the possible pathologic mechanism of VC caused by smoking. Methods The inci-dence of VC in patients smoking ( actively or passively) after replanted operation was compared with that of no smoking. The occuring time and treatment result of VC were assayed. The influence on replantation in active smoking was assimilated with passive smoking. Results Cigarette smoking postoperatively could enhance ob-viously the incidence of VC of replanted digits. The rate of VC in passive smokers was higer than in active smokers. The VC caused by postoperative smoking largely (94.87%) happened within 14 days, of which 85.33% was artery crisis, 6.67% vein crisis and 8.0% mixed one. The factor of obstinate contraction exceed markedly the thrombus factor. Conclusion Cigarette smoking after replanted operation is a main factor of inducing VC of amputated fingers and affecting survival of replanted digit and cutting down the quality of alive fingers. Continuous constraction of finger artery and increasing of bloody viscosity were major pathologic mechanism of VC.