【摘要】 目的评估选择性COX-2抑制剂(帕瑞昔布、塞来昔布)在手屈肌腱损伤修复术后的镇痛效果、安全性以及对手功能恢复的影响。方法选取2016年11月至2019年11月锐器伤致手屈肌腱Ⅱ、Ⅲ、Ⅳ区损伤成人患者32例,随机分为COX-2抑制剂组和曲马多组,每组16例。记录2组术后的运动性疼痛VAS评分和不良反应进行组间比较,对2组术后的手功能采用TAM评价并进行比较。结果 COX-2抑制剂组患者术后锻炼时的运动性疼痛VAS评分更低,差异有统计学意义(P<0.05);COX-2抑制剂组在给药后发生恶心呕吐的不良反应数少于曲马多组,差异有统计学意义(P<0.05);2组在头痛头晕、乏力嗜睡的不良反应数比较上差异无统计学意义(P>0.05);COX-2抑制剂组的手功能恢复更佳,差异有统计学意义(P<0.05)。结论应用COX-2抑制剂用于手部屈肌腱损伤后的围手术期治疗,镇痛效果确切,不良反应少,术后手功能恢复满意。更多还原

【Abstract】 Objective To investigate the analgesic effects, safety and effects of selective COX2 inhibitors(parecoxib, celecoxib) on hand function recovery after flexor tendon repair operation.Methods A total of 32 adult patients with zone Ⅱ, Ⅲ and Ⅳ injury of flexor tendon caused by sharp instrument were randomly divided into COX2 inhibitor group(n=16) and tramadol group(n=16). The VAS scores and adverse reactions after operation were observed and compared between the two groups. The postoperative hand function in both groups was evaluated by TAM.Results The VAS scores of exercise pain at physical training after operation in COX2 inhibitor group were significantly lower than those in tramadol group(P<0.05). The incidence rates of adverse reactions including nausea and vomiting after medication in COX2 inhibitor group were significantly lower than those in tramadol group(P<0.05). However there were no significant differences in the incidence rates of adverse reactions including headache, dizziness, fatigue, sleepiness between the two groups(P>0.05). Moreover the recovery of hand function in COX2 inhibitor group was superior to that in tramadol group(P<0.05).Conclusion The application of COX2 inhibitor in perioperative treatment of hand flexor tendon injury has definite analgesic effects, with less adverse reactions and satisfactory hand functional recovery after surgery.更多还原