非甾体抗炎药预防全髋关节置换术后异位骨化
Prevention of heterotopic ossification after total hip replacement with NSAIDs.
作者信息
Fijn Roel, Koorevaar Rinco Th, Brouwers Jacobus R
机构信息
Groningen University Institute for Drug Exploration (GUIDE), Groningen Research Institute of Pharmacy (GRIP), Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, University of Groningen, Groningen, The Netherlands.
出版信息
Pharm World Sci. 2003 Aug;25(4):138-45. doi: 10.1023/a:1024830213832.
INTRODUCTION
Non steroidal anti-inflammatory drugs (NSAIDs) and prophylactic radiotherapy can prevent ectopic bone formation around the hip after total hip arthroplasty.
METHODS
We retrieved from Medline, Embase and the Cochrane Register (clinical) trials and other relevant literature on the prevention of heterotopic ossification (HO) from 1990-2002 for further review.
RESULTS
Review of these clinical trials shows that HO is effectively prevented by a postoperative NSAID treatment with indomethacin for at least seven days. The best evidence is available for indomethacin, although naproxen, diclofenac and ibuprofen are also well documented. Short term use of ibuprofen is not effective. If NSAIDs are contraindicated, preoperative or postoperative radiotherapy is a very effective therapeutic option to prevent HO.
DISCUSSION AND CONCLUSION
Because of the potential of serious gastrointestinal side effects of NSAIDs and their interaction with anticoagulant drugs, rofecoxib and other COX-2 specific NSAIDs may be a safer option for the treatment of HO. However, randomised controlled studies are needed to confirm the results of the rofecoxib study.
引言
非甾体抗炎药（NSAIDs）和预防性放射治疗可预防全髋关节置换术后髋关节周围异位骨形成。
方法
我们从Medline、Embase和Cochrane注册库（临床试验）中检索了1990年至2002年期间关于预防异位骨化（HO）的试验及其他相关文献，以供进一步审查。
结果
对这些临床试验的审查表明，术后使用消炎痛进行至少七天的NSAIDs治疗可有效预防HO。消炎痛有最佳证据支持，尽管萘普生、双氯芬酸和布洛芬也有充分记录。短期使用布洛芬无效。如果NSAIDs有禁忌，术前或术后放射治疗是预防HO的非常有效的治疗选择。
讨论与结论
由于NSAIDs有严重胃肠道副作用的可能性及其与抗凝药物的相互作用，罗非昔布和其他COX-2特异性NSAIDs可能是治疗HO的更安全选择。然而，需要随机对照研究来证实罗非昔布研究的结果。
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