塞来昔布预防根管治疗期间急症的临床评价

目的 比较一次性和二次性根管治疗后根管治疗期间急症(EIAE)的发生率及急性发作程度(FUI),评价应用塞来昔布的预防效果.方法 按纳入标准选取在湖南旺旺医院口腔科就诊的225例牙髓坏死并有根尖周X线透射阴影需行根管治疗的患牙,采用逐步后退法制备根管,随后将患者随机分为两组:塞来昔布组113例,根管预备后口服塞来昔布,其中55例行一次性根管治疗,58例行二次性根管治疗;安慰剂组112例,根管预备后口服外形和颜色一致的安慰剂,一次性根管治疗和二次性根管治疗各56例.记录两组患者根管治疗后l周内出现的症状.结果 一次性根管治疗组EIAE的发生率及FUI均值均明显高于二次性根管治疗组(P＜0.05).塞来昔布组EIAE的发生率及FUI值分别为5.31％、(2.58±0.64),明显低于安慰剂组的13.39％、(4.08±0.79),差异有统计学意义(P＜0.05).塞来昔布对一次性根管治疗术后的EIAE发生率及FUI值具有明显的抑制作用(P＜0.05).结论 根管制备后预防性服用塞来昔布可显著降低EIAE的发生率、减轻术后疼痛及肿胀程度.

A clinical evaluation of prophylactic use of celecoxib on endodontic interappointment emergencies

Objective To compare the effect of prophylactic use of celecoxib on endodontic interappointment emergencies(EIAE) and flare up index(FUI) between single-and multiple-visit procedures.Methods Two hundred and twentyfive patients with necrotic pulps and asymptomatrc periapical radiolucencies attending for endodontic therapy in Hunan Want Want Hospital were selected for this study.At the initial visit,all teeth were instrumented completely to the radiographic apex by stepback preparation procedure,2.5% sodium hypochlorite was used as the irrigant.The patients were randomly divided into two groups,the celecoxib group and the placebo group.Patients in the celecoxib group(n= 113) were given celecoxib and then randomly divided into single-visit endodontic treatment group(n=55) and multiplevisit endodontic treatment group(n=58).The placebo group(n=112) consisted of a single-visit endodontic treatment group(n=56) and multiple-visit endodontic treatment group(n=56).An identical-appearing placebo with instructions to take one tablets every day for three days.The symptoms occurred within 1 week were recorded after root canal instrumentation.Results The incidences of EIAE and FUI in single-visit group were significantly higher than the multiple-visit group(P<0.05).EIAE in the placebo group(13.39%) was significantly higher than the celecoxib group(5.3%)(p<0.05).FUI in placebo group(4.08±0.79) was significantly higher than the celecoxib group(2.58±0.64)(P<0.05).Conclusion Prophylactic use of celecoxib can effectively reduce the incidence of EIAE and relieve postoperative pain and swelling.