CAJ | 학술논문

目的评价帕瑞昔布钠对全膝关节置换术(total knee arthroplasty,TKA)和全髋关节置换术(total hip arthroplasty,THA)术后的镇痛效果. 方法本研究为前瞻性、随机、双盲研究,由同一组医师完成101例TKA患者和105例THA患者,根据镇痛方式分为三组:(1)术中静脉注射帕瑞昔布钠组；(2)术中关节局部注射帕瑞昔布钠组；(3)对照组.比较术后三组的视觉模拟疼痛评分(VAS)、关节活动度(ROM)、术后直腿抬高能力和恶心、呕吐等并发症的发生率. 结果术中静脉注射帕瑞昔布钠组和术中关节局部注射帕瑞昔布钠组在术后各时段的VAS评分和术后24 h ROM及直腿抬高能力的差异无统计学意义(P＞0.05),但均明显优于对照组(P＜0.05).使用帕瑞昔布钠后恶心、呕吐等并发症的发生率没有显著增加. 结论术中静脉注射和术中关节局部注射帕瑞昔布钠对TKA和THA术后的镇痛效果确切,有利于患者关节功能的迅速康复,且操作简便、实用,是TKA和THA镇痛的有效方法之一.
목적 평개파서석포납대전슬관절치환술(total knee arthroplasty,TKA)화전관관절치환술(total hip arthroplasty,THA)술후적진통효과. 방법 본연구위전첨성、수궤、쌍맹연구,유동일조의사완성101례TKA환자화105례THA환자,근거진통방식분위삼조:(1)술중정맥주사파서석포납조；(2)술중관절국부주사파서석포납조；(3)대조조.비교술후삼조적시각모의동통평분(VAS)、관절활동도(ROM)、술후직퇴태고능력화악심、구토등병발증적발생솔. 결과 술중정맥주사파서석포납조화술중관절국부주사파서석포납조재술후각시단적VAS평분화술후24 h ROM급직퇴태고능력적차이무통계학의의(P＞0.05),단균명현우우대조조(P＜0.05).사용파서석포납후악심、구토등병발증적발생솔몰유현저증가. 결론 술중정맥주사화술중관절국부주사파서석포납대TKA화THA술후적진통효과학절,유리우환자관절공능적신속강복,차조작간편、실용,시TKA화THA진통적유효방법지일.
Objective To evaluate the analgesic effect of parecoxib in total knee arthroplasty (TKA) and total hip arthroplasty (THA).Methods The study was a prospective,randomized and double-blind trial and was operated by the same group of surgeons in 101 patients with TKA and 105 patients with THA.According to analgesic protocol,the patients were divided into three groups:Group One ( intravenous injection with parecoxib),Group Two ( periarticular injection with parecoxib) and Group Three ( the control group).The postoperative visual analog scores (VAS),range of motion ( ROM),the ability of straight leg raising and the incidence of nausea and vomiting complications were examined and compared between the three groups.Results There were no significant differences in VAS (6,12,24,36,48,72 hours after operation),ROM ( 24 hours after operation) and the ability of straight leg raising between Group One and Group Two ( P ＞ 0.05 ),but all of them were significantly higher than those in Group Three ( P ＜ 0.05 ).Nausea,vomiting and other adverse effects did not significandy increase with the use of parecoxib.Conclusions Both intraoperative intravenous injection and periarticular injection with parecoxib have a good analgesia effect on TKA and THA,which are beneficial to the rapid recovery of joint function in patients.The simple and practical method provides an effective adjunct to a multimodal analgetic approach in improving the postoperative course of TKA and THA.