塞来昔布胶囊联合低分子肝素注射液治疗膝关节置换术后应激反应的临床研究  

Clinical trial of celecoxib capsules combined with low molecular weight heparin injection in the treatment of knee joint replacement with stress reaction

作　　者：张金陵[1] 荣根祥[1] 唐智[1] 桂斌捷[1] ZHANG Jin-ling;RONG Gen-xiang;TANG Zhi;GUI Bin-jie(Department of Orthopaedics,First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China)

机构地区：[1]安徽医科大学第一附属医院骨科,安徽合肥230022

出　　处：《中国临床药理学杂志》2020年第11期1470-1473,共4页The Chinese Journal of Clinical Pharmacology

基　　金：安徽省公益性研究联基金资助项目(1704f0804029)。

摘　　要：目的探讨塞来昔布联合低分子肝素对膝关节置换术患者术后应激反应、关节功能及静脉血栓的预防作用。方法依据随机数字表法将119例膝关节置换术患者分为对照组58例和试验组61例。对照组在术后24 h时予以低分子肝素4000 U,皮下注射,qd,持续7 d;再替换为阿司匹林100 mg,口服,qd,持续4周。在对照组基础上,试验组术后2 d予以塞来昔布0.1 g,口服,bid,持续6 d。用酶联免疫吸附法测定2组手术前后应激反应指标,用美国纽约特种外科医院(HSS)评分评价关节功能,观察2组下肢深静脉血栓形成(DVT)发生率和药物不良反应(ADR)发生情况。结果术后7 d,试验组和对照组的儿茶酚胺分别为(382.70±44.74)和(425.09±45.74)ng·L^-1;这2组的皮质醇分别为(272.65±30.40)和(294.16±42.19)ng·L^-1;这2组的去甲肾上腺素分别为(866.53±74.30)和(898.09±68.46)pmol·L^-1;这2组的HSS评分分别为(80.36±4.44)和(75.29±7.41)分。上述指标:组间比较差异均有统计学意义(均P<0.05)。术后14周,试验组和对照组DVT发生率分别为1.64%(1例次/61例次)和12.07%(7例次/58例次),组间比较差异有统计学意义(P<0.05);对照组和试验组总ADR发生率分别为6.90%和14.75%,组间比较差异无统计学意义(P>0.05)。结论塞来昔布联合低分子肝素能减轻膝关节置换术后应激反应,改善关节功能,且可预防DVT发生。Objective To investigate the effects of celecoxib combined with low molecular weight heparin on postoperative stress response,joint function and venous thrombosis in patients undergoing knee arthroplasty.Methods Patients with knee arthroplasty were randomly divided into two groups according to random table number:58 cases in control group and 61 cases in treatment group.The control group was given low molecular weight heparin 4000 U,subcutaneous injection,qd,for 7 d;24 h after operation,replaced with aspirin 100 mg,oral,qd,for 4 weeks.The treatment group was given celecoxib on the basis of the control group,and 0.1 g of celecoxib was given orally at 2 d after operation,bid,for 6 d.Enzyme-linked immunosorbent assay was used to measure the stress response indexes of the two groups before and after operation.The joint function was evaluated by the Hospital for Special Surgery(HSS).The incidence of deep venous thrombosis(DVT)and adverse drug reactions(ADR)were observed in two groups.Results Seven days after operation,catecholamines contents in treatment group and control group were(382.70±44.74)and(425.09±45.74)ng·L^-1;cortisol contents in the two groups were(272.65±30.40)and(294.16±42.19)ng·L^-1,norepinephrine contents in the two groups were(866.53±74.30)and(898.09±68.46)pmol·L^-1;and HSS score in the two groups were(80.36±4.44)and(75.29±7.41)point,the differences of the factors were statistically significant between the two groups(all P<0.05).At 14 weeks after operation,the incidences of DVT in treatment group and control group were 1.64%(1 case/61 cases)and 12.07%(7 cases/58 cases)with statistically significant difference(P<0.05).The incidences of total ADR in control group and treatment group were 6.90%and 14.75%,without statistical difference(P>0.05).Conclusion Celecoxib combined with low molecular weight heparin can reduce the stress reaction after knee arthroplasty,improve joint function and prevent DVT.

关 键 词：塞来昔布 低分子肝素 膝关节置换术 应激反应 关节功能 静脉血栓 

分 类 号：R97[医药卫生—药品]