Effect of non-steroidal anti-inflammatory drugs on postoperative healing of patients with clavicle fracture
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摘要:
目的 探讨非甾体抗炎药对锁骨骨折患者术后愈合的影响，为临床用药提供依据。 方法 将120例锁骨骨折术后患者随机分为试验组和对照组，每组60例，试验组于术后第1天开始口服塞来昔布200 mg，2次/d，疗程7 d，对照组不给予任何非甾体抗炎药及阿片类镇痛药；采用VAS评分评估两组患者术后疼痛情况，记录不良事件；于术后4、8、12周对两组患者骨折部位进行X线检查，评估骨折愈合情况。 结果 采用塞来昔布治疗后，试验组患者VAS评分较对照组降低（4.08±1.05分 vs 8.07±0.84分, P<0.05），4、8、12周的骨膜反应评分均高于对照组（1.15±0.33、2.02±0.34、2.60±0.49分，P<0.05），而骨痂出现率、骨折愈合评分、骨骼塑形评分均低于对照组（P<0.05）。 结论 非甾体抗炎药塞来昔布对锁骨骨折的愈合可能具有不利影响。 Abstract:Objective To investigate the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on postoperative healing of patients with clavicle fracture, and to provide basis for clinical medication. Methods 120 patients with clavicle fracture were randomly divided into experimental group and control group, with 60 cases in each group. Patients in experimental group took celecoxib orally 200 mg bid for 7 days after operation, while the control group was not given any NSAIDs or opioid analgesics. The VAS score was used to evaluate the postoperative pain in two groups, and adverse reactions were recorded. The X-ray was used to evaluate the postoperative healing of fracture sites at 4, 8 and 12 weeks after operation respectively. Results After the treatment of celecoxib, the VAS score in experimental group was significantly decreased than that in control group (4.08±1.05vs 8.07±0.84, P<0.05), and the scores of periosteal reaction at 4, 8 and 12 weeks were significantly higher than those in the control group (scores of periosteal reaction at 4, 8 and 12 weeks in experimental group: 1.15±0.33, 2.02±0.34, 2.60±0.49,P<0.05), while the incidence of callus, score of fracture healing and skeletal shape were significantly lower than those of the control group (P<0.05). Conclusion Celecoxib, a nonsteroidal anti-inflammatory drug, has an adverse effect on the healing of clavicular fractures. -
Key words:
- non-steroidal anti-inflammatory drugs /
- clavicle fracture /
- healing /
- effect
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表 1 术后疼痛VAS评分比较（Mean±SD, 分）
组别 术后时间 1 h 3 h 6 h 12 h 24 h 36 h 48 h 72 h 试验组 5.21±0.76 5.13±0.72 6.36±1.10 7.86±0.89 7.92±0.85 4.08±1.05 3.78±0.90 4.31±1.21 对照组 5.33±0.65 5.08±0.69 6.53±1.03 7.65±0.92 8.13±0.70 8.07±0.84 7.98±0.95 7.82±0.85 t 0.900 0.386 0.854 1.312 1.524 22.985 18.929 18.266 P >0.05 >0.05 >0.05 >0.05 >0.05 <0.05 <0.05 <0.05 
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表 2 不良反应发生情况[n（%）]
组别 恶心 呕吐 头晕 其他 试验组 8（13.3） 7（11.7） 9（15.0） 2（3.3） 对照组 3（5.0） 2（3.3） 1（1.7） 1（1.7） χ2 2.502 3.003 6.982 0.342 P >0.05 >0.05 <0.05 >0.05
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表 3 骨痂出现情况[n（%）]
组别 术后 4周 8周 12周 试验组 9（15.0） 28（46.7） 41（68.3） 对照组 30（50.0） 52（86.7） 57（95.0） χ2 16.752 21.600 14.249 P <0.05 <0.05 <0.05
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表 4 不同时间段X线片骨折愈合评分（Mean±SD, 分）
组别 骨膜反应（0~3分） 骨折愈合（0~3分） 骨骼塑形（0~2分） 4周 8周 12周 4周 8周 12周 4周 8周 12周 试验组 1.15±0.33 2.02±0.34 2.60±0.49 0.72±0.49 1.33±0.48 2.12±0.61 0.15±0.36 1.07±0.25 1.38±0.24 对照组 0.70±0.65 1.18±0.54 1.93±0.52 1.15±0.40 2.55±0.50 2.92±0.28 1.10±0.35 1.88±0.32 1.98±0.02 t 4.025 10.128 7.226 5.281 13.636 9.200 14.570 15.423 9.167 P <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05 <0.05
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