昔布类药物在人工全髋关节置换术超前镇痛中的应用研究进展  

Research progress on application of COXIBs in preemptive analgesia of total hip arthroplasty

作　　者：樊航(综述) 郑稼(审校) FAN Hang;ZHENG Jia(Department of Orthopedics,Henan University People′s Hospital/Henan Provincial People′s Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南大学人民医院/河南省人民医院骨科,郑州450003

出　　处：《重庆医学》2021年第21期3750-3754,共5页Chongqing medicine

基　　金：科技部国家重点研发计划子计划项目(122300411149)。

摘　　要：人工全髋关节置换术(THA)是终末期髋关节骨病治疗的重要手段。但THA创伤大,术后易出现中重度疼痛,不利于患者术后早期的康复训练,影响患者术后关节功能的恢复,降低手术效果。围术期超前应用镇痛药物可有效防止伤害性刺激的传入,减轻或消除术后疼痛。非甾体抗炎药(NSAIDs)通过抑制环氧化酶(COX)活性,发挥消炎镇痛作用。但传统NSAIDs对COX-1的抑制会导致严重的胃肠道毒性,不良反应较大;而对COX-2高选择抑制剂——昔布类药物(COXIBs)具有良好的选择性,在抑制炎症和镇痛的同时有效避免了对胃肠道等的相关损害。目前,COXIBs在THA超前镇痛中的应用已成为骨科研究关注的热点,该文就COXIBs在THA超前镇痛中的应用进展进行了综述。Total hip arthroplasty(THA)is an important treatment means of end-stage hip osteopathy.But THA has the large trauma and is easier to appear moderate to severe pain after surgery,which is not conducive to early postoperative rehabilitation training,affects the recovery of hip function and reduces the surgery effect.The preemptive application of analgesics during the perioperative period can effectively prevent the introduction of noxious stimuli so as to relieve or eliminate the postoperative pain.Non-steroidal anti-inflammatory drugs(NSAIDs)exert the anti-inflammatory and analgesic effects by inhibiting the activity of cyclooxygenase(COX).However,the inhibition of traditional NSAIDs on COX-1 can lead to severe gastrointestinal toxicity and large adverse reactions;the COX-2 highly selective inhibitor COXIBs have good selectivity,in the inflammation inhibition and analgesia,at the same time effectively avoid the gastrointestinal tract and other related damage.At present,the COXIBs application in THA preemptive analgesia has become a hot spot focused by orthopedic research.This article reviews the application progress of COXIBs in ERAS preemptive analgesia of THA.

关 键 词：人工全髋关节置换术 加速康复 超前镇痛 昔布类药物 

分 类 号：R684.7[医药卫生—骨科学]