CAJ | 학술논문

目的观察围手术期口服塞来昔布对膝部骨折内固定术术后疼痛评分、镇痛药物的使用、睡眠情况、不良反应及膝关节活动范围的影响.方法病人随机分为2组,每组20例,实验组术前3 d起给予塞来昔布200 mg口服,2次/d,持续至术后7 d;对照组术前给予复合维生素片,术后予塞来昔布200 mg口服,2次/d,持续至术后7 d.术毕2组均使用静脉自控镇痛48 h,术后2、4,8、16、24、48 h采用视觉模拟评分(VAS)评价患者疼痛程度,调查患者睡眠满意度和不良反应情况,记录术后每日芬太尼用量,及术后2周膝关节活动度.结果 2组间用药前VAS疼痛评分差异无统计学意义(P>0.05),但术后实验组各个时点的VAS值均低于对照组相应的VAS值(P<0.05);实验组术后睡眠满意度高于对照组(P<0.01),术后24 h需要芬太尼剂量低于对照组(P<0.05).不良反应与对照组无明显区别(P>0.05),出院时膝关节活动度大于对照组(P<0.05).结论围手术期使用塞来昔布用于膝部骨折手术具超前镇痛作用,能有效缓解术后疼痛,减少术后镇痛药的使用,改善睡眠满意度,改善膝关节活动范围,有利于膝关节功能恢复.
목적 관찰위수술기구복새래석포대슬부골절내고정술술후동통평분、진통약물적사용、수면정황、불량반응급슬관절활동범위적영향.방법 병인수궤분위2조,매조20례,실험조술전3 d기급여새래석포200 mg구복,2차/d,지속지술후7 d;대조조술전급여복합유생소편,술후여새래석포200 mg구복,2차/d,지속지술후7 d.술필2조균사용정맥자공진통48 h,술후2、4,8、16、24、48 h채용시각모의평분(VAS)평개환자동통정도,조사환자수면만의도화불량반응정황,기록술후매일분태니용량,급술후2주슬관절활동도.결과 2조간용약전VAS동통평분차이무통계학의의(P>0.05),단술후실험조각개시점적VAS치균저우대조조상응적VAS치(P<0.05);실험조술후수면만의도고우대조조(P<0.01),술후24 h수요분태니제량저우대조조(P<0.05).불량반응여대조조무명현구별(P>0.05),출원시슬관절활동도대우대조조(P<0.05).결론 위수술기사용새래석포용우슬부골절수술구초전진통작용,능유효완해술후동통,감소술후진통약적사용,개선수면만의도,개선슬관절활동범위,유리우슬관절공능회복.
Objective To evaluate the effects of perioperative administration of celecoxib in patients underwent treatment of fractures around the knee by internal fixation. Methods Forty patients scheduled for treatment of fractures around the knee by internal fixation were randomly divided into celecoxib group (group C)and placebo group (group P) with 20 cases in each group. Celecoxib 200mg or placebo was given in group C or P twice daily for 3 days before surgery. All patients were given celecoxib 200mg twice daily for 7 days and patient-controlled intravenous Analgesia ( PCIA ) for 48 h after surgery. Pain extent was evaluated using visual analog scale (VAS) after operation. The analgesic requirements, side effects, knee joint ranges of motion,sleep states were compared. Results There were no marked differences in the VAS pain scores before celecoxib administration between 2 groups. Compared with group P, the patients of group C had lower VAS pain scores after the operation ( P < 0.05). Compared with group P, a lower total consumption of other analgesics was observed in patients of group C for first 24 hours after the operation ( P <0.01). It was also found that the sleep satisfaction scores in group C were higher than that in group P ( P < 0.05). There were no significant differences in respect to the side effects between 2 groups ( P > 0.05). A larger hip joint ranges of motion was observed in patients of group C that group P ( P < 0.05). Conclusion Perioperative administration of celecoxib in patients undergoing the treatment of fractures around the knee by internalfixation can alleviate the postoperative pain score, reduce postoperative other analgesics consumption, meantime, it can improve knee joint ranges of motion and sleep states.