CAJ | 학술논문

目的：探讨美洛昔康对骨科术后的阵痛疗效及其安全性。方法随机选择2011年1月至2012年5月来我院就诊的78例骨科手术患者,所有患者均在术后1 h、24 h肌注15 mg美洛昔康进行镇痛,对镇痛疗效不理想者给予芬太尼注射液进行补充镇痛。评估患者疼痛程度,记录患者术前和术后1周血常规、肝肾功能的变化情况,观察治疗时有无药物相关的不良事件发生。结果患者大手术、中手术、小手术用药前(术后1 h) VAS评分分别为9．2、8．1、7．9,用药后各时间点与基线VAS评分比较有明显下降(P<0．05),使用美洛昔康术后镇痛整体疗效满意；各组疼痛缓解率结果显示,美洛昔康对不同类型手术均有良好的镇痛效果；小型手术患者使用美洛昔康的镇痛效果优于大、中手术患者(P<0．05)。所有患者在术后拔出安置的引流管时,未发生引流量增多等异常现象；治疗期间患者未发生手术切口严重出血、胃痛、胃溃疡、恶心呕吐等与美洛昔康相关的不良反应；未发生心律失常、心肌梗死等不良反应。结论美洛昔康可有效缓解骨科术后疼痛,无明显不良反应,临床用药安全,是有效的骨科术后镇痛药。
목적：탐토미락석강대골과술후적진통료효급기안전성。방법수궤선택2011년1월지2012년5월래아원취진적78례골과수술환자,소유환자균재술후1 h、24 h기주15 mg미락석강진행진통,대진통료효불이상자급여분태니주사액진행보충진통。평고환자동통정도,기록환자술전화술후1주혈상규、간신공능적변화정황,관찰치료시유무약물상관적불량사건발생。결과환자대수술、중수술、소수술용약전(술후1 h) VAS평분분별위9．2、8．1、7．9,용약후각시간점여기선VAS평분비교유명현하강(P<0．05),사용미락석강술후진통정체료효만의；각조동통완해솔결과현시,미락석강대불동류형수술균유량호적진통효과；소형수술환자사용미락석강적진통효과우우대、중수술환자(P<0．05)。소유환자재술후발출안치적인류관시,미발생인류량증다등이상현상；치료기간환자미발생수술절구엄중출혈、위통、위궤양、악심구토등여미락석강상관적불량반응；미발생심률실상、심기경사등불량반응。결론미락석강가유효완해골과술후동통,무명현불량반응,림상용약안전,시유효적골과술후진통약。
Objective To explore the efficacy and safety of meloxicam on orthopedics postoperative analgesi-a. Methods 78 patients with ulcerative colitis in our hospital from January 2011 to May 2012 were chosen,and all the patients were respectively injected with 15 mg meloxicam for analgesia at 1 h and 24 h after operation. Fentanyl analge-sia was added to the patients with incompletely analgesic. The extent of pain was assessed,and the change of blood rou-tine examination,liver and kidney function were recorded before and at 1 week after operation. The drug-related adverse events was observed. Results The VAS scores of patients with major surgery,moderate surgery and minor surgery be-fore treatment (1 h after surgery) were 9. 2,8. 1,7. 9;and the VAS score decreased significantly after medication (P<0. 05). The postoperative analgesia effect was satisfactory after using meloxicam. The analgesic effect of meloxicam on different types of operation were good. The analgesic effect of meloxicam in patients with minor surgery was better than those with major surgery and moderate surgery ( P <0. 05 ) . No abnormal phenomenon flow increase was observed when drainage tube was drawn out. During treatment,no severe bleeding in surgical incision,stomach pain,stomach ul-cers,nausea,vomit was observed. There was no arrhythmia,myocardial infarction and other adverse events. Conclusion Meloxicam can effectively relieve orthopedic postoperative pain without obvious adverse reaction,it is an effective orthopedic postoperative analgesics with good safety.