CAJ | 학술논문

目的：探索术后6周连续应用环氧化酶-2（COX-2）抑制剂对全膝关节置换术（TKA）术后镇痛和功能恢复的效果，探索TKA术后镇痛的新方法。方法选取73例即将接受TKA的单侧膝关节骨关节炎的患者，随机分为2组，术前以及在术后2周内住院期间所有患者常规口服塞来昔布，术后2周出院，出院后实验组继续口服塞来昔布直至术后6周；对照组服用安慰剂胶囊至术后6周。观察术前、术后3天、2周、6周、6个月、12个月疼痛改善和膝关节功能恢复情况以及并发症发生情况。结果实验组和对照组在术前、术后3天和术后2周的疼痛VAS评分、膝关节HSS评分未见明显统计学差异。随访至术后6周、6月、12个月时，实验组VAS评分明显低于对照组（ t＝2.73、2.89、3.21；P＜0.01）、HSS评分明显高于对照组（t＝1.98、2.66、2.81；P＜0.01）。结论 TKA术后连续6周口服环氧化酶-2抑制剂有助于减轻患者的疼痛，并促进膝关节功能恢复。
목적：탐색술후6주련속응용배양화매-2（COX-2）억제제대전슬관절치환술（TKA）술후진통화공능회복적효과，탐색TKA술후진통적신방법。방법선취73례즉장접수TKA적단측슬관절골관절염적환자，수궤분위2조，술전이급재술후2주내주원기간소유환자상규구복새래석포，술후2주출원，출원후실험조계속구복새래석포직지술후6주；대조조복용안위제효낭지술후6주。관찰술전、술후3천、2주、6주、6개월、12개월동통개선화슬관절공능회복정황이급병발증발생정황。결과실험조화대조조재술전、술후3천화술후2주적동통VAS평분、슬관절HSS평분미견명현통계학차이。수방지술후6주、6월、12개월시，실험조VAS평분명현저우대조조（ t＝2.73、2.89、3.21；P＜0.01）、HSS평분명현고우대조조（t＝1.98、2.66、2.81；P＜0.01）。결론 TKA술후련속6주구복배양화매-2억제제유조우감경환자적동통，병촉진슬관절공능회복。
Objective To observe the analgesic effects of the 6-week application of the COX-2 inhibitors after total knee arthroplasty ( TKA ) and to confirm a new analgesic method .Methods 73 patients were enrolled and were randomly divided into two groups .All the patients took celecoxib orally before and after TKA for 2 weeks until the patients discharged from the hospital .The experimental group continued taking celecoxib while the control group took the placebo orally until six weeks after the operation.The knee joint function and the pain complaint were observed preoperatively and at three days , two weeks, six weeks, six and 12 months after the TKA.Results There was no statistical difference in VAS and HSS scores before the surgery and three days , two weeks after the TKA (P<0.01).The analysis showed statistical difference in VAS and HSS scores six weeks after the TKA .Conclusion The COX-2 inhibitors have definite analgesic effect when taken after TKA for six weeks and may help to improve the knee joint function .