Cameron Hannum, Pharm.D.
Sr. Clinical Account Pharmacist
在工伤赔偿中，吸烟对医疗和康复过程有什么影响?
烟草使用和吸烟对健康和整体个人福祉有着广泛的影响, 包括对医疗结果和伤口愈合过程产生负面影响的能力. In the context of workers’ compensation, 受伤员工在哪里接受治疗和康复, understanding the impact of tobacco use is of particular importance.
Effects of Tobacco on Wound and Bone Healing
吸烟已被证明会严重损害伤口愈合过程. 即使抽一根烟也会降低身体为术后愈合提供必要营养的能力. Several studies, including those from the National Institutes of Health (NIH) and the World Health Organization (WHO), have demonstrated that smoking weakens the immune system, delays and prolongs wound healing, increases the chance, severity and duration of infections at the wound site, 并对手术的总体结果和术后并发症产生负面影响.
Although the precise mechanisms are not entirely understood, the process of wound healing is intricate. However, it is estimated that cigarette smoke contains over 4,000 harmful substances, including nicotine, hydrogen cyanide and carbon monoxide. 这些化合物会引起炎症和缺氧(低血氧), negatively impacting the healing process.
Nicotine, a key component of tobacco, has been shown to constrict blood vessels, leading to reduced blood flow to the wound site. 这减少了最佳愈合所需的氧气和营养的输送. Moreover, 尼古丁抑制了参与伤口愈合的各种细胞类型的增殖和迁移, including fibroblasts and endothelial cells.
Through research, tobacco has also been shown to negatively influence bone healing, particularly in the context of fractures and orthopedic procedures. Smoking has been associated with delayed fracture healing, increased rates of nonunion (when bones fail to heal), and higher risks of implant failure.
烟草对骨愈合的有害影响可归因于多种因素, including impaired blood flow, hypoxia, altered cellular activity, and disrupted signaling pathways crucial for bone regeneration. Furthermore, 吸烟已被发现对骨密度有负面影响, increasing the risk of osteoporosis and subsequent fractures.
对治疗结果的影响和对工人赔偿的影响
了解烟草使用对医疗和伤口愈合在工人赔偿中的影响具有重要意义. 治疗中一个值得关注的领域涉及使用阿片类药物来控制疼痛. 烟草使用者往往表现出更严重和更持久的慢性疼痛, often requiring a higher frequency of opioid use. Interestingly, current tobacco use via traditional cigarettes or e-cigarettes, 非医疗或非处方阿片类药物使用的潜在风险是一个强有力的预测指标吗.
Smoking has been associated with increased pain levels, 手术或医疗干预后住院时间延长，功能预后降低. 与烟草使用有关的愈合延迟和并发症风险增加也可导致长期残疾, protracted time away from work, and higher medical costs for employers and insurance providers. 认识到吸烟对治疗结果的负面影响可以影响综合工人赔偿方案的发展，这些方案将戒烟支持作为量身定制的康复和恢复计划的组成部分. By offering tobacco cessation interventions, 雇主和付款人可以帮助受伤的雇员优化他们的康复过程, 提高治疗效果，并有助于整体上更快地重返工作岗位.
研究一贯表明，烟草使用对医疗结果和愈合过程产生有害影响. Smoking delays wound and bone healing, 增加手术后并发症的风险，并干扰某些药物的疗效. 了解这些影响对于制定包括戒烟支持在内的综合策略的工人补偿计划至关重要. By addressing tobacco use, employers can enhance treatment effectiveness, 促进更快的愈合，并最终提高整体福祉和结果受伤的员工在工人的赔偿制度.
This information is meant to serve as a general overview, 任何具体的问题或担忧都应该与你的医疗保健专业人员，如开处方的医生或配药的药剂师进行更全面的审查.
你有工伤赔偿或与汽车相关的药品问题吗? Send us an email at AskThePharmacist@tovtops.com.
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References:
http://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery#:~:text=Smoking%20distorts%20a%20patient's%20immune,nutrients%20for%20healing%20after%20surgery
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241583/
http://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00459-4/fulltext
http://pubmed.ncbi.nlm.nih.gov/26375198/#:~:text=Smokers%20present%20with%20more%20severe%20and%20extended%20chronic,of%20risk%20for%20nonmedical%20use%20of%20prescription%20opioids.