【摘要】 目的 系统评价塞来昔布用于骨科手术患者超前镇痛的有效性及安全性。方法系统检索PubMed、Embase、Web of Science、the Cochrane Library、万方数据库、中国知网（CNKI）、维普（VIP）数据库和中国生物医学文献服务系统（SinoMed），收集塞来昔布超前镇痛用于骨科手术患者的随机对照试验（RCT），采用RevMan 5.4软件进行Meta分析。结果 共纳入11项RCT，合计985例患者。Meta分析结果显示，静息状态下试验组患者术后12 h[MD=-0.48,95%CI(-0.83,-0.14),P=0.006]、24 h[MD=-0.40,95%CI(-0.58,-0.21),P<0.000 1]、48 h[MD=-0.31,95%CI(-0.51,-0.11),P=0.002]、72 h[MD=-0.21,95%CI(-0.34,-0.07),P=0.003]的视觉模拟评分法（VAS）评分均显著低于对照组。活动状态下试验组患者术后6 h[MD=-0.49,95%CI(-0.86,-0.11),P=0.01]、24 h[MD=-0.46,95%CI(-0.68,-0.24),P<0.000 1]、48 h[MD=-0.24,95%CI(-0.44,-0.05),P=0.02]的VAS评分均显著低于对照组。两组患者术后6 h静息状态下VAS评分和术后72 h活动状态下VAS评分比较差异无统计学意义（P>0.05）。试验组患者术后恶心呕吐[RR=0.72,95%CI(0.57,0.91),P=0.006]、心血管不良反应[RR=0.24,95%CI(0.06,0.93),P=0.04]的发生率显著低于对照组。两组患者术后便秘、头晕嗜睡、皮肤瘙痒的发生率差异无统计学意义（P>0.05）。结论 在骨科手术中，使用塞来昔布进行超前镇痛可减轻患者术后早期疼痛，降低术后恶心呕吐及心血管不良反应的发生率。更多还原

【Abstract】 Objective To systematically evaluate the efficacy and safety of celecoxib for preemptive analgesia in patients undergoing orthopedic surgery. Methods PubMed, Embase, Web of Science, the Cochrane Library, Wanfang database, CNKI, VIP and SinoMed were systematically searched to collect randomized controlled trials about the use of celecoxib for preemptive analgesia in patients undergoing orthopedic surgery. RevMan 5.4 software was used for Meta-analysis. Results A total of 11 RCTs were included, with a total of 985 patients. The results of the Meta-analysis showed that in the resting state, the VAS scores of patients in the trial group were significantly lower than those in the control group at 12 h [MD=-0.48, 95%CI(-0.83,-0.14), P=0.006], 24 h [MD=-0.40, 95%CI(-0.58,-0.21), P<0.000 1], 48 h [MD=-0.31, 95%CI(-0.51,-0.11), P=0.002] and 72 h [MD=-0.21, 95%CI(-0.34,-0.07), P=0.003] after surgery. In the active state, the VAS scores of patients in the trial group were significantly lower than those in the control group at 6 h [MD=-0.49, 95%CI(-0.86,-0.11), P=0.01], 24 h [MD=-0.46, 95%CI(-0.68,-0.24), P<0.000 1], 48 h [MD=-0.24, 95%CI(-0.44,-0.05), P=0.02] after surgery. There was no statistically significant differences in the VAS scores between the two groups at 6h after surgery in the resting state and at 72 h after surgery in the active state(P>0.05). The incidence of postoperative nausea and vomiting [RR=0.72, 95%CI(0.57, 0.91), P=0.006] and cardiovascular adverse reactions [RR=0.24, 95%CI(0.06, 0.93), P=0.04] was significantly lower in the trial group than in the control group. There was no statistically significant difference in the incidence of postoperative constipation, dizziness, somnolence, and skin itching between the two groups(P>0.05). Conclusion In orthopedic surgery, the use of celecoxib for preemptive analgesia can alleviate early postoperative pain and reduce the incidence of postoperative nausea, vomiting, and cardiovascular adverse reactions in patients..更多还原