COX―2抑制剂在全膝关节置换术术后镇痛效果研究.docVIP

COX―2抑制剂在全膝关节置换术术后镇痛效果研究 　　[摘要] 目的 探讨COX-2抑制剂在全膝关节置换术术后镇痛的效果。 方法 选择我院骨科2014年1月～2015年1月行单膝TKA术的患者70例，按照就诊顺序分为观察组和对照组，各35例。观察组在自控镇痛基础上采用COX-2抑制剂帕瑞昔布钠、赛来昔布序贯疗法；对照组在自控镇痛基础上口服胶囊安慰剂。观察两组镇痛效果、COX-2和PGE2水平、膝关节活动度、不良反应。 结果 两组静息状态下，观察组各时间点的疼痛评分均低于对照组，但差异无统计学意义（P0.05）；两组运动状态下，观察组各时间点的疼痛评分均明显低于对照组，差异有高度统计学意义（P0.01）；两组间术后48 h血清COX-2水平比较，差异有高度统计学意义（P0.01）；两组间手术结束时、术后48 h血清PGE2水平比较，差异有高度统计学意义（P0.01）；两组患者出院时，观察组患侧膝关节主动活动角度、被动活动角度数值均高于对照组，组间比较，差异有统计学意义（P0.05）；观察组4例患者出现胃肠道不适，但程度较轻，不影响继续用药，两组均未出现切口感染、头痛头晕、消化道出血以及切口延迟愈合等不良反应。 结论 TKA术后应用COX-2抑制剂有助于减轻患者的疼痛，并促进膝关节功能恢复。 　　[关键词] COX-2抑制剂；全膝关节置换术；镇痛；疼痛 　　[中图分类号] R687.42；R614 [文献标识码] B [文章编号] 1673-9701（2016）13-0133-04 　　Effect study of COX-2 inhibitors on postoperative analgesia of total knee arthroplasty 　　DU Zhongju ZHANG Hua 　　Department of Anesthesiology， Hangzhou Third Peoples Hospital， Hangzhou 310000， China 　　[Abstract] Objective To investigate the effect of COX-2 inhibitors on the postoperative analgesia of total knee arthroplasty（TKA）. Methods Seventy patients who received single knee TKA in the orthopedic department of our hospital from January 2014 to January 2015 were selected and divided into the observation group and the control group according to the admission sequence， with 35 patients in each group. The observation group was given COX-2 inhibitors parecoxib sodium and celecoxib sequential therapy on the basis of patient-controlled analgesia. The control group was given oral administration of capsule placebo on the basis of patient-controlled analgesia. The analgesic effects， levels of COX-2， PGE2， active activity angel， adverse reaction of the two groups were observed. Results Under rest state， the observation group was lower than the control group in the pain scores at all the time points， but between-group comparison showed no statistically significant differences（P0.05）. Under motion state， the observation group was significantly lower than the control group in the pain scores at all the time points and between-gro