目的 探讨吸烟对行腭垂腭咽成形术的男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者术后恢复的影响和可能的机制.方法 将OSAHS患者按是否吸烟分为吸烟组(n=65)和非吸烟组(n=47).比较两组患者术后机械通气时间、术后呕吐发生率、住ICU时间和住院总时间,检测患者动脉血气及手术前后超敏C反应蛋白(hs-CRP)、白介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平.结果 与非吸烟组相比,吸烟组患者术后机械通气时间[(6.4±2.1)h 比(4.3±1.3)h ]、术后呕吐发生率[21.54% 比12.77%]、住ICU时间[(25.5±4.5)h 比(18.4±3.6)h ]和住院总时间[(7.3±2.2)d 比(5.3±1.3)d ]差异均有统计学意义(P＜0.05).吸烟组患者术后各时间点氧合指数均低于非吸烟组,但差异均无统计学意义(P＞0.05).与非吸烟组相比,吸烟组患者术后hs-CRP[(36.08±3.67)mg/L 比(21.34±2.51)mg/L]、TNF-α[(69.5±4.3)ng/L 比(48.3±3.6)ng/L]和IL-6[(185.0±6.2)ng/L 比(125.0±5.7)ng/L]比较差异均有统计学意义(P＜0.05).结论 吸烟对男性OSAHS患者术后恢复造成不良影响,其可能机制是吸烟患者术后炎性反应较非吸烟患者剧烈,影响术后器官功能的恢复.%Objective To investigate the effect of smoking on postoperative recovery of uvulopalatopharyngoplasty and its possible mechanisms in men with obstructive sleep apnea - hypopnea syndrome ( OSAHS ) . Methods The OSAHS patients were divided as smoking group ( n = 65 ) and non - smoking group ( n = 47 ) . The time of mechanical ventilation after the operation , postoperative vomiting incidence, time of ICU stay and total hospital stay. Arterial blood gas analysis was tested after the operation. The levels of high - sensitivity C - reactive protein ( hs - CRP ), tumor necrosis factor alpha ( TNF - α ) and interleukin 6 ( IL - 6 ) were tested before and after the operation. Results Compared with the non - smoking group, the patients in the smoking group had a longer time of mechanical ventilation [ ( 6. 4 ± 2. 1 ) h vs. ( 4. 3 ± 1. 3 ) h ], a higher incidence of postoperative nausea and vomiting [ 21. 54% vs. 12. 77% ], a longer period of ICU stay [ ( 25. 5 ±4. 5 ) h vs. ( 18. 4 ± 3. 6 ) h ] and a longer hospitalization [ ( 7. 3 ± 2. 2 ) d vs. (5.3±1.3) d ], with statistically significant differences ( P < 0. 05 ) . The patients in the smoking group had a lower postoperative oxygenation index, but with no statistically significant difference ( P > 0. 05 ) . However, the differences in hs - CRP ( ( 36. 08 ± 3. 67 ) mg/L vs. ( 21. 34 ±2. 51 ) mg/L ), TNF - α [ ( 69. 5 ±4. 3 ) ng/L vs. (48.3±3.6) ng/L ] and IL - 6 [ (185.0 ±6. 2) ng/L vs. (125.0 ±5. 7) ng/L ] were statistically significant ( P <0. 05 ). Conclusion Smoking can give an adverse impact on the postoperative recovery for male OSAHS patients. The possible mechanism might be that the smokers have a more intense postoperative inflammation response, which impacts the recovery of organic functions.
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