摘要
背景:髋膝关节置换是临床上常见的手术,相对比较复杂,风险也相对比较高,使得患者置换后镇痛效果并不理想。围置换期疼痛处理一直是临床所关注的问题,寻找安全、有效的镇痛方法,已经成为关节外科医生的重要任务之一。目的:探讨塞来昔布在髋膝关节置换后多模式镇痛中的效果。方法:从重庆市东南医院2012年9月至2013年9月收治的髋膝关节置换患者中选择80例进行分析,按随机数字表法分为两组,对照组置换后不使用塞来昔布镇痛,试验组置换后采用塞来昔布镇痛。观察两组患者置换后1-5 d的疼痛情况,记录止痛泵撤除时药物所剩剂量及阿片类止痛药物使用情况,统计患者使用镇痛药物后的药物不良反应。结果与结论:在镇痛疗效方面,试验组镇痛方案效果显著,明显优于对照组(95%,85%,P<0.05);试验组95%对镇痛满意,显著高于对照组65%(P<0.05)。两组患者置换当天、置换后第4,5天手术切口疼痛的目测类比评分差异无显著性意义(P>0.05);试验组置换后第1,2,3天手术切口疼痛的目测类比评分均显著低于对照组(P<0.05)。试验组置换后止痛药物剩余量显著多于对照组(P<0.05),阿片类药物使用次数显著低于对照组(P<0.05)。试验组并发症发生率为8%,显著低于对照组18%(P<0.05)。提示髋膝关节置换后多模式镇痛下使用塞来昔布镇痛效果理想,能够减少止痛药物使用剂量,药物不良反应少。
BACKGROUND： Hip and knee replacement is a common surgery in the clinic; the procedure is relatively complex; and the risk of surgery is relatively high, so that postoperative analgesia is not satisfactory. Perioperative pain management has been a clinical concern. To find safe and effective analgesia has become one of the important tasks of joint surgeons. OBJECTIVE： To investigate the effect of celecoxib on multi-mode analgesia after hip and knee replacement. METHODS： A total of 80 cases undergoing hip and knee replacement in the Chongqing Dongnan Hospital from September 2012 to September 2013 were enrolled in this study. These patients were randomly divided into two groups. In the control group, celecoxib was not used for analgesia after replacement. In the experimental group, celecoxib was used after replacement. The pain was observed at 1-5 days after surgery in the two groups. When the analgesic pump was removed, the drug dosage and opioid analgesics use were recorded. Side effects of drug use were also recorded. RESULTS AND CONCLUSION： In terms of analgesic efficacy, the analgesic effect was better in the experimental group than in the control group（95%, 85%, P〈0.05）. 95% patients in the experimental group were satisfied with the analgesia, which was significantly higher than in the control group（65%; P〈0.05）. Nosignificant difference in pain visual analogue scale score was detected between the two groups immediately, 4 and 5 days after surgery（P〉0.05）. Pain visual analogue scale score was significantly lower in the experimental group than in the control group at 1, 2 and 3 days post surgery（P〈0.05）. The drug dosage was significantly more in the experimental group than in the control group after surgery（P〈0.05）. The frequency of opioid use in the experimental group was significantly lower than in the control group（P〈0.05）. The complication rate was significantly lower in the experimental group（8%） than in the control group（18%）（P〈0.05）. These finding
出处
《中国组织工程研究》
CAS
北大核心
2015年第44期7065-7070,共6页
Chinese Journal of Tissue Engineering Research
