应用选择性环氧合酶-2抑制剂在全膝关节置换术后的疗效及安全性  

Effectiveness and safety of selective COX-2 inhibitor application in the patients after total knee arthroplasty

作　　者：丁裕润[1] 王博[1] 王伟力[1] 沈奕[1] 王圆[2] 

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海200127 [2]上海交通大学医学院附属第九人民医院麻醉科,上海200011

出　　处：《药学服务与研究》2016年第5期339-341,共3页Pharmaceutical Care and Research

摘　　要：目的:比较分析选择性环氧合酶-2抑制剂帕瑞昔布和塞来昔布对人工全膝关节置换术后关节功能康复的影响。方法:回顾性分析上海交通大学医学院附属仁济医院2012年1月至2014年12月行人工全膝关节置换术病人144例,64例术后口服塞来昔布,40例静脉推注帕瑞昔布,40例对照组未使用止痛药物,比较术后疼痛情况及膝关节功能恢复情况。结果:2例应用帕瑞昔布及3例应用塞来昔布的病人出现一过性恶心呕吐,未出现过敏,消化道出血,肝、肾功能不全等严重药品不良反应。手术时间、术中出血量及住院天数3项指标两两比较差异无统计学意义(P>0.05)。术后1d和术后3d视觉模拟评分(visual analogue scale,VAS)组间差异有统计学意义(P<0.05)。术后美国膝关节协会评分(American Knee Society Score,KSS)临床评分、KSS功能评分组间差异有统计学意义(P<0.05)。结论:人工全膝关节置换术后应用选择性环氧合酶-2抑制剂病人疼痛明显减轻,早期膝关节功能恢复更好,应用针剂帕瑞昔布效果优于口服塞来昔布。Objective： To compare clinical effectiveness and safety between parecoxib and celecoxib after total knee arthro- plasty （TKA）. Mothods： A retrospective analysis was made on the 144 patients with TKA hospitalized in Renji Hospital from January 2012 to December 2014. Of all the cases, 64 were given oral celecoxib （assigned as the celecoxib group）, 40 received intravenous injection of parecoxib （assigned as the parecoxib group）, and another 44 did not have any painkillers （assigned as the control group）. Pain and recovery of joint function after surgery were compared between the 3 groups. Results： Two cases in the parecoxib group and 3 cases in the celecoxib group had transient nausea and vomiting, and there were no such serious ad- verse drug reactions as allergy, digestive canal bleeding and hepto and renal insufficiency. No statistical significance could be noted, when comparisons were made between the 3 clinical indicators （the surgery time, the amount of hemorrhage in surgery and days of hospital stay） （P〉 0.05）. However, there was statistical significance in the scores of visual analogue scale （VAS）, when comparisons were made the first and third day after surgery between the 3 groups （P〈0.05）. After surgery, clinical evaluation was made by using the American Knee Society Score （KSS）, and there were statistical differences in KSS scores, when comparisons were made between the 3 groups （P〈0.05）. Conclusion： After TKA, the application of selective COX-2 inhibitors could reduce pain and promote early recovery of joint function. The efficacy of parecoxib injection was obviously superior to that of oral celecoxib.

关 键 词：选择性环氧合酶-2抑制剂 塞来昔布 帕瑞昔布 人工全膝关节置换术 视觉模拟评分 美国膝关节协会评分 

分 类 号：R982[医药卫生—药品]