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塞来昔布对全膝关节置换术后手术部位炎症的影响:一项随机对照研究。

Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study.

出版信息

Med Princ Pract. 2018;27(5):481-488. doi: 10.1159/000492922. Epub 2018 Sep 13.

Abstract

OBJECTIVE

To evaluate the anti-inflammatory effectiveness of celecoxib and its effect on the rehabilitation of joint function after total knee arthroplasty.

METHODS

72 patients presented between 2016 and 2017 and were divided into two groups. The experimental group was given 200 mg celecoxib twice daily with tramadol hydrochloride 50 mg twice daily (as required); the control group was given tramadol hydrochloride 50 mg twice daily for 6 weeks from the first day after total knee arthroplasty. Skin temperature around the knee was measured 1 day before surgery, on postoperative days 1 and 3, and at weeks 1, 2, and 6. Inflammatory markers (white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6) were measured preoperatively, on postoperative day 3, and at weeks 1 and 6. Knee Society Score was recorded preoperatively and at postoperative weeks 1, 2, and 6.

RESULTS

Except for preoperative skin temperature, the recorded skin temperatures of the experimental group were significantly different compared to those of the control group (p = 0.001, 0.024, 0.030, 0.041, 0.047, respectively). Levels of C-reactive protein were significantly different at the 1st and the 6th week after surgery, differing by 19.3 ± 4.64 mg/L (p < 0.001) and 2.6 ± 0.92 mg/L (p = 0.006). Levels of interleukin-6 showed a significant difference of 6.61 ± 2.36 pg/mL (p = 0.007) at the 1st week after surgery. Until the 6th week after surgery, the erythrocyte sedimentation rate in the experimental group and the control group differed by 17 ± 4.6 mm/h (p = 0.001).

CONCLUSIONS

Celecoxib has a significant inhibitory effect on postoperative aseptic inflammation.

摘要

目的

评估塞来昔布的抗炎效果及其对全膝关节置换术后关节功能康复的影响。

方法

纳入 2016 年至 2017 年期间的 72 例患者,分为两组。实验组给予塞来昔布 200mg,每日两次,同时给予盐酸曲马多 50mg,每日两次(必要时服用);对照组从全膝关节置换术后第一天起,每天给予盐酸曲马多 50mg,连续 6 周。在术前 1 天、术后第 1 天和第 3 天以及第 1、2、6 周测量膝关节周围皮肤温度。在术前、术后第 3 天以及第 1、6 周测量炎症标志物(白细胞计数、C 反应蛋白、红细胞沉降率和白细胞介素-6)。在术前和术后第 1、2、6 周记录膝关节学会评分。

结果

除术前皮肤温度外,实验组记录的皮肤温度与对照组相比差异均有统计学意义(p=0.001、0.024、0.030、0.041、0.047)。术后第 1、6 周 C 反应蛋白水平差异有统计学意义,分别相差 19.3±4.64mg/L(p<0.001)和 2.6±0.92mg/L(p=0.006)。术后第 1 周白细胞介素-6 水平差异有统计学意义,相差 6.61±2.36pg/mL(p=0.007)。术后第 6 周,实验组和对照组红细胞沉降率相差 17±4.6mm/h(p=0.001)。

结论

塞来昔布对术后无菌性炎症有明显抑制作用。

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