前交叉韧带重建术后不同非甾体抗炎药物疗效的前瞻随机对照研究  

Prospective randomized controlled study on curative effects of different non-steroidal anti-inflammatory drugs after anterior cruciate ligament reconstruction

作　　者：潘玲[1] 李坚[1] 卓鸿武 PAN Ling;LI Jian;ZHUO Hongwu(Department of Sports Injuery,Fuzhou Second Hospital,Fuzhou 350007,China)

机构地区：[1]福州市第二医院运动损伤科,福建福州350007

出　　处：《中国医药科学》2019年第1期13-17,共5页China Medicine And Pharmacy

基　　金：福建省自然科学基金资助项目(2016J01481)

摘　　要：目的比较塞来昔布、依托考昔和氟比洛芬脂在前交叉韧带(ACL)重建术后早期的止痛效果、安全性以及对ACL腱-骨愈合的影响。方法 2014年1～12月ACL重建术后接受非甾体抗炎(NSAIDs)药物治疗的患者60例。采用随机数字表法将患者分为塞来昔布、依托考昔和氟比洛芬脂组,每组20例。术后1～5天采用疼痛视觉模拟评分(VAS)评估疼痛缓解情况,并观察是否出现用药不良反应。末次随访时采用核磁评估ACL腱-骨愈合情况,采用IKDC、Lysholm和Tegner评分评估膝关节功能。结果三组患者术前一般资料差异无统计学意义(P> 0.05)。患者接受NSAIDs药物后疼痛均逐渐缓解。术后当天及术后1～3天,氟比洛芬脂组VAS评分显著优于其他两组,差异有统计学意义(术后当天,第1、2、3天静止相和活动相分别为F=5.653,P=0.006,F=3.532,P=0.036;F=4.163,P=0.021,F=5.038,P=0.010;F=3.184,P=0.048,F=3.736,P=0.030;F=3.364,P=0.043,F=3.303,P=0.044)。但术后第4～5天,三组VAS评分差异无统计学意义(P> 0.05)。三组患者用药期间均未出现消化道出血或急性肾衰等不良反应。末次随访时,三组患者ACL腱-骨均获得完全愈合,且术后IKDC、Lysholm和Tegner评分差异均无统计学意义(P> 0.05)。结论塞来昔布、依托考昔和氟比洛芬脂作为ACL重建术后止痛药物,其止痛效果良好,安全性较高,对术后ACL腱-骨愈合无显著影响。Objective To compare the early antalgic effect,safety and effect on ACL tendon-bone healing of celecoxib,etoricoxib and flurbiprofen axetil after anterior cruciate ligament(ACL)reconstruction.Methods Sixty patients who were treated with non-steroidal anti-inflammatory drugs(NSAIDs)after ACL reconstruction from January 2014 to December 2014were selected.They were divided into celecoxib group,etoricoxib group and flurbiprofen axetil group according to random number table method,with 20 cases in every group.Pain relief was evaluated by visual analogue scale(VAS)on 1 to 5 days after operation and adverse drug reactions were observed.At final follow-up,magnetic resonance imaging was used to assess the ACL tendon-bone healing.IKDC,Lysholm and Tegner scale were used to assess the knee joint function.Results There was no significant difference in preoperative general data among the three groups(P >0.05).After receiving NSAIDs drugs,all patients experienced gradual relief of pain.On the day after surgery and 1 to 3 days after surgery,VAS score of the flurbiprofen axetil group was significantly better than the other two groups.The difference was statistically significant(on the day after surgery and 1 to 3 days after surgery,static phase and active phase were respectively F=5.653,P=0.006,F=3.532,P=0.036;F=4.163,P=0.021,F=5.038,P=0.010;F=3.184,P=0.04 8,F=3.736,P=0.030;F=3.364,P=0.043,F=3.303,P=0.044).Difference in VAS scores of 4 to 5 days after surgery in three groups had no statistical significance(P >0.05).No adverse reactions such as gastrointestinal hemorrhage or acute renal failure occurred in the three groups during medication.At final follow-up,ACL tendon-bone in three groups was all healed and difference in postoperative IKDC,Lysholm and Tegner scorehad no statistical significance(P >0.05).Conclusion Celecoxib,etoricoxib and flurbiprofen axetilas analgesics after ACL reconstruction,they have a good antalgic effect and high safety and they have no significant influence on ACL tendon-bone healing.

关 键 词：韧带 重建 非甾体抗炎药 愈合 镇痛 

分 类 号：R686.5[医药卫生—骨科学]