塞来昔布联合局部放疗预防肘关节骨化性肌炎的早期效果观察  

Early preventive effect of celecoxib combined with local radiotherapy on myositis ossificans following surgical treatment for elbow joint: report of 244 cases

作　　者：陈锐 郭珊成 

机构地区：[1]解放军第422医院骨科,广东湛江524005

出　　处：《第三军医大学学报》2015年第24期2468-2471,共4页Journal of Third Military Medical University

摘　　要：目的比较塞来昔布及局部放疗联合疗法与单一疗法预防肘关节术后骨化性肌炎的早期疗效。方法回顾性分析2008-2012年我院收治的肘关节外伤患者资料,筛选后纳入本研究并有效随访244例,分为塞来昔布组77例、局部放疗组65例、联合治疗组102例。最后1次随访时根据美国特种外科医院(hospital for special surgery,HSS)肘关节功能评分、疼痛数字评价量表(numerical rating scale,NRS)、肘关节活动度(range of motion,ROM)、影像学表现进行疗效评价。结果联合治疗组HSS评分和肘关节活动度分别为(93.04±6.68)分和(124.02±15.61)°,优于塞来昔布组[(89.61±9.62)分,(116.36±23.81)°](P<0.01)和局部放疗组[(89.92±9.21)分,(117.23±17.96)°](P<0.05);NRS评分和骨化性肌炎发生率:联合治疗组比塞来昔布组和局部放疗组有所改善,但差异无统计学意义(P>0.05);各组均无明显不良反应。结论塞来昔布联合局部放疗预防骨化性肌炎的早期效果优于单一疗法,且无明显不良反应。Objective To compare the early preventive effects of celecoxib-radiotherapy combined therapy and single therapy on the myositis ossificans following surgical treatment for elbow joint. Methods Clinical data of elbow joint trauma patients in our hospital from January 2008 to January 2013 were collected and retrospectively analyzed. A total of 244 patients were enrolled and followed up effectively, and they were divided into celecoxib group （n=77）, local radiotherapy group （n=65）, and combined therapy group （n=102）. The clinical outcomes were assessed in regard of hospital for special surgery （HSS） functional rating scores, numerical rating scale （NRS）, range of motion （ROM）, and radiographic findings in the last follow-up. Results The HSS functional rating score and ROM [93.04±6.68 and 124.02°±15.61°] in the combined therapy group were significantly better than [89.61±9.62 and 116.36°±23.81°] in the celecoxib group （P〈0.01） and [89.92±9.21 and 117.23°±17.96°] in the radiotherapy group （P〈0.05）. The NRS score and the morbidity of myositis ossificans were improved more in the combined therapy group, but the differences were not statistically significant compared with the 2 single therapy groups （P〉0.05）. No obvious adverse events were found in the 3 groups. Conclusion The combined therapy of celecoxib and local radiotherapy is superior to the single therapy in the early preventive effect of myositis ossificans following surgical treatment for elbow joint, and there are no obvious adverse events.

关 键 词：塞来昔布 骨化性肌炎 放射治疗 

分 类 号：R685.2[医药卫生—骨科学] R815[医药卫生—外科学]