柯岩;刘强;王锴;林剑浩;

• 1:北京大学人民医院骨关节

摘要(Abstract)：

[目的]评估塞来昔布对TKA术后早期疼痛、炎症反应、功能康复、患者满意度及生活质量的影响。[方法] 80例接受单侧膝关节置换手术病例随机分为给药组及对照组,术后持续给予患者自控静脉镇痛48 h。给药组围手术期应用塞来昔布,而对照组未应用此药物。比较两组的疼痛评分、双侧腿围差值,双侧皮温差值、术后早期反应指标,KSS评分、WOMAC评分及SF-12评分和患者自我满意度CASI评分等临床功能指标,以及外周血及关节滑液检测炎症因子水平。[结果]术后早期给药组的疼痛评分、双侧腿围差、双侧皮温差均显著小于对照组(P<0.05))。术后早期两组患者KSS评分随时间推移均显著增加(P<0.05),给药组的KSS评分、WOMAC评分及SF-12的躯体部分评分均显著优于对照组(P<0.05)。给药组的患者满意度CASI评分在术后2周时显著高于对照组(P<0.05),但术后6周时两组间差异无统计学意义(P>0.05)。术后两组CRP持续明显升高,至术后48 h达峰值,尔后下降,至术后6周恢复至术前水平;在术后24 h、48 h及2周时,给药组的血清CRP水平均显著低于对照组(P<0.05)。术后外周血中检测到IL-6和Il-8均显著低于关节滑液,仅为关节滑液中的1/10～40。给药组关节滑液的IL-6和IL-8均显著低于对照组(P<0.05)。[结论] TKA手术围手术期应用选择性COX-2抑制剂塞来昔布,不仅缓解疼痛,还可降低术后早期反应,改善关节功能、提高患者满意度,有利于术后早期康复。

关键词(KeyWords)： 塞来昔布;全膝关节置换术;疼痛;术后早期;前瞻性研究

Abstract:

Keywords:

基金项目(Foundation): 北京市科学技术委员会项目(编号：D121100004212003)

作者(Author): 柯岩;刘强;王锴;林剑浩;

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