反射性交感神經失養症與吸煙之相關性研究

The Correlation between Reflex Sympathetic Dystrophy Syndrome and Smoking

李承益(Cheng-Yi Li) ； 倪壽民(Shou-Min Ni) ； 何丁舜(Ding-Shun Ho) ； 林修平(Shiou-Ping Lin) ； 喬桓(Huan Chiao) ； 蔡高宗(Kao-Chung Tsai)

《中華民國復健醫學會雜誌》 30卷4期 (2002/12) Pp. 227-233

摘要

反射性交感神經失養症(RSDS)常發生於輕度傷害之後而難以預防，其症狀之劇烈與療效不佳常讓醫療人員頗為困擾。由於抽煙會對交感神經系統產生影響，本研究希望調查吸煙對RSDS發生是否有關。研究對象以民國85年至90年間於本院收療經診斷為反射性交感神經失養症者，以病歷回顧方式，針對此病之誘發原因、發病部位及吸煙與此病發生率之關聯性等，依各種身分別作一完整分析，統計分析採用卡方檢定，以p值小於0.05為有意義之差異。另外，為進一步探討RSDS患者與吸煙之間相關性，再計算其危險對比值（odds ratio）以及其95﹪信賴區間(confidence interval)。研究結果發現誘發原因中以創傷居多，約佔總數之60%。此病發生之部位，則以肢體之遠端為好發部位，約佔74%。本研究亦發現吸煙與反射性交感神經失養症的發生有顯著關聯，本研究所收集RSDS病患(實驗組)之吸煙危險因子暴露率，明顯高於非RSDS隨機抽樣之本院住院病患(對照組)，兩者具有明顯之統計意義，p值小於0.001。而整體患者與吸煙之危險對比值為2.70，其95﹪信賴區間為1.82~4.00。由本次的研究結果得知，吸煙對於反射性交感神經失養症的發生有明顯的相關性，這個結果應可作為日後更深入研究之參考。

關鍵字

反射性交感神經失養症 ； 吸煙

並列摘要

Reflex sympathetic dystrophy syndrome (RSDS) is a chronic painful syndrome, which may cause extreme pain and disability of the involved limbs of the patients. The unknown of causes of RSDS keep patients and clinicians from early prevention of this syndrome. Smoking may affect the sympathetic system. The purpose of this study was to find whether smoking has the prominent correlation with the morbidity of RSDS.
This is a retrospective study by surveying the medical records of patients with RSDS admitted in Tri-Service General Hospital from January 1996 to December 2001. The possible trigger factors, lesion sites and the prevalence of smoking of these RSDS patients were investigated.
The results of our study had shown that 60% of the RSDS patients were caused by trauma. Distal part of limbs was the prevalent site for RSDS, holding 74% of all cases. We also found that smoking had a significant correlation with the morbidity of RSDS. The risk factor exposure rate of smoking for the RSDS patients (experimental group) is much higher than the randomly selected patients (control group). There was a significant difference between these two groups with the pvalue less than 0.001. The odds ratio, which represented the correlation between whole RSDS patients in this study and smoking, was 2.70 and the 95﹪confidence interval was between 1.82 to 4.00. Additional studies to investigate the underlying mechanisms how smoking interacts with RSDS could be helpful for the treatment or prevention of RSDS.

並列關鍵字

reflex sympathetic dystrophy syndrome ； smoking