塞来昔布在膝关节镜下前交叉韧带重建围手术期镇痛的效果分析  

Evaluation of the analgesic efficacy of celecoxib in the perioperative period of anterior cruciate ligament reconstruction with arthroscope

作　　者：闫昌葆[1] 陈百成[1] 刘虎[1] 赵宝辉[1] 李嘉[1] 

机构地区：[1]河北医科大学第三医院关节骨科,石家庄050051

出　　处：《中国矫形外科杂志》2009年第22期1689-1691,共3页Orthopedic Journal of China

摘　　要：[目的]研究塞来昔布在膝关节镜下自体腘绳肌腱前交叉韧带重建围术期应用的镇痛效果。[方法]采用随机对照研究方法,对90例前交叉韧带损伤患者行膝关节镜下自体腘绳肌腱重建术,随机分为3组,其中A组应用传统PCA镇痛,B组应用塞来昔布辅助曲马多镇痛,C组采用塞来昔布超前镇痛辅助曲马多镇痛。通过比较3组的术后各时间点VAS评分、术后不良反应发生率及辅助曲马多用量来比较3种方法的临床效果。[结果]术前3组患者年龄、体重、病情等基本情况无差别。术后6、12、24、48h,C组及A组VAS评分无差别且均小于B组(P6,12,24,48<0.05);术后A组不良反应发生率为43.3%。大于B组的16.7%及C组的20.0%(x2=6.3920,P=0.0115);术后A组辅助曲马多用量最少,而B组最多(F24=84.93,P24<0.0001;F48=117.13,P48<0.0001)。术后各组中患者均恢复良好,伤口均一期愈合,未出现严重的并发症及过敏反应。[结论]膝关节镜下自体腘绳肌腱前交叉韧带重建围术期应用塞来昔布超前镇痛辅助盐酸曲马多的镇痛方法,其镇痛效果好,不良反应低,具有良好的临床效果和安全性。[ Objective] To evaluate the analgesic efficacy of celecoxib after hamstring grafts anterior cruciate ligament（ACL） reconstruction with arthroscope. [ Method ] A randomised control trial was carried out in 90 patients who received unilateral ACL reconstruction ,and they were divided in to three groups. Group A was analgesic by traditional patient-controlled Analgesia（ PCA）, group B was analgesic by celecoxib assisted tramadol, and group C was analgesic by celecoxib preoperative analgesia assisted tramadol. The three groups were compared with Visual Analogue Score （VAS） , adverse reaction incidence rate, and the Tramadol dose of postoperation to evaluate the clinical effect. [ Result] The age,weight and the pathogenetic of patients had no difference preoperatively. After 6 hours, 12 hours ,24 hours and 48 hours of operation, the VAS of group C and group A had no difference, and group B showed larger than those in other two groups （P6,12,24,48 〈 0.05 ） ;the adverse reaction incidence rate of group A was 43.3% higher than 16.7% of group B and 20.0% of group C（ x^2 = 6.3920 ,P = 0.0115 ）. The tramadol dose of group A was the least,the group B was the most（ F24 = 84.93, P24 〈 0.0001, F48 = 117.13, P48 〈 0.0001 ）. All patients recovered well, the wound was primary healing, no serious complications and anaphylaxis was found. [ Conclusion] The analgesic efficacy of celecoxib in the perioperative period of anterior cruciate ligament reconstruction with arthroscope is fine, adverse reaction incidence is litde, the clinical effect and security are excellent.

关 键 词：前交叉韧带重建 镇痛 塞来昔布 

分 类 号：R614[医药卫生—麻醉学] R687.2[医药卫生—外科学]