全膝关节置换术后应用6周环氧化酶-2抑制剂的疗效分析

目的探索术后6周连续应用环氧化酶乏（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。

Effect analysis of six-week application of COX-2 inhibitor after total knee arthroplasty

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.