镇痛药影响骨质疏松性骨折愈合的临床观察  

Effect of Analgesics on the Healing of Osteoporotic Fracture

作　　者：黄亚峰[1] 

机构地区：[1]沈阳医学院附属二院骨科,辽宁沈阳110035

出　　处：《中国医院用药评价与分析》2015年第3期304-306,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:探讨镇痛药对于骨质疏松性骨折愈合的影响。方法:选取2010年3月—2014年2月收治的200例骨质疏松性骨折患者,其中,129例患者术后疼痛感明显,故给予镇痛药缓解疼痛。将疼痛不明显、术后未用镇痛药的71例患者设为对照组,仅给予碳酸钙D3片治疗;以随机数字表法将疼痛感明显的患者分为观察组A(64例)、观察组B(65例),观察组A给予碳酸钙D3片、双氯芬酸钠联合治疗,观察组B给予碳酸钙D3片、盐酸曲马多联合治疗。连续用药7 d后,观察3组患者骨折愈合情况。结果:患者术后平均骨折愈合时间方面,对照组为(6.4±1.2)个月,观察组A为(7.8±1.4)个月,观察组B为(6.5±1.1)个月,观察组A明显长于对照组和观察组B,差异均有统计学意义(P<0.05);此外,观察组A患者的L1-L4骨密度平均值与骨折愈合情况也均显著差于对照组和观察组B,差异均有统计学意义(P<0.05);而观察组B与对照组的差异则无统计学意义(P>0.05)。结论:骨质疏松性骨折患者因剧烈疼痛会采用中枢性镇痛药或非甾体抗炎药进行镇痛治疗,但非甾体抗炎药可延长骨折愈合时间,而中枢性镇痛药则对骨折愈合无明显影响。OBJECTIVE： To investigate the effect of analgesics on the healing of osteoporotic fracture. METHODS：200 patients with osteoporotic fracture treated between March 2010 and February 2014 were enrolled,in which 129 cases showing significant postoperative pain were assigned to observation group treated with analgesics for pain relief,and the other 71 cases showing insignificant postoperative pain were assigned to control group treated with calcium D3 tablets alone. The 129 cases in the observation group were randomly subdivided into observation group A（ 64 patients）treated with calcium D3 tablets plus diclofenac and observation group B（ 65 patients） treated with calcium D3 tablets plus tramadol hydrochloride. The fracture healing in the three groups after medication for 7 consecutive days were evaluated. RESULTS： The mean healing time of the postoperative fracture was（ 6. 4 ± 1. 2） months for the control group,as compared with（ 7. 8 ± 1. 4） months for the observation group A and（ 6. 5 ± 1. 1） months for observation group B,indicating significantly longer healing time in observation group A than in the other two groups（ control group and observation group B）,and the differences were statistically significant（ P〈0. 05）; in addition,the mean bone density of L1-L4 and the fracture healing status in observation group A were also significantly worse than in the other two groups（ control group and observation group B）,and the differences were statistically significant（ P〈0. 05）;however,the differences between observation group B and the control group were not statistically significant（ P〈0. 05）. CONCLUSIONS： Patients with osteoporotic fracture might be treated with central analgesics or non-steroidal anti-inflammatory analgesics for management of severe pain,but non-steroidal anti-inflammatory drugs can prolong the healing time while the effect of the central analgesics on fracture healing is insignificant.

关 键 词：非甾体抗炎药 中枢性镇痛药 骨质疏松性骨折 骨折愈合 

分 类 号：R971.1[医药卫生—药品]