非甾体类药预防性治疗肘部外伤术后并发骨化性肌炎

Non-steroid anti-inflammatory drugs in the prophylactic treatment of ossifying myositis following surgical treatment for elbow injury

目的探讨非甾体类药预防性治疗肘部外伤术后并发骨化性肌炎的疗效。方法对比研究我院2007年5月～2010年2月肘部外伤术后服用非甾体类药物塞来昔布(63例,药物治疗组)和未服用塞来昔布(75例,对照组)患者临床资料。药物治疗组从术后第1天开始口服塞来昔布,200mg/次,1次/d,应用2周。观察术后6周、3个月、1年碱性磷酸酶(ALP)、肘关节正侧位X线片、肘关节功能恢复情况。结果药物治疗组63例随访12～45个月,术后6周、3个月及1年ALP平均值分别为(65.0±5.3)、(69.1±8.9)、(58.4±12.2)mmol/L;发生骨化性肌炎2例,发生率为3.1%。对照组69例随访12～65个月,术后6周、3个月及1年ALP平均分别为(97.6±29.3)、(73.3±11.1)、(62.5±15.3)mmol/L;发生骨化性肌炎7例(10.1%)。ALP在术后6周有明显统计学差异(P<0.05),术后3个月及1年无明显统计学差异。对照组肘关节骨化性肌炎发生率高于药物治疗组,有统计学差异(P<0.05)。结论肘部外伤术后患者常规应用非甾体类药有利于预防肘关节骨化性肌炎发生。

Objective To discuss the effect of non-steroid anti-inflammatory drugs（NSAID） in preventing ossifying myositis after surgical treatment of elbow trauma.Methods From May.2007 to Feb.2010,Celecoxib（200mg qd for 2 weeks） were applied in 63 patients with elbow trauma postoperatively（treatment group）,comparing with 75 patients without NSAID treatment（control group）.Data including alkaline phosphate（ALP）,X-ray of injured elbow（AP and lateral position） were obtained at 3 time points：6th weeks,3rd months and 1st year after surgeries.SPSS 13.0 software was used to evaluate the differences between the two groups.Results All patients received NSAID treatment,and the follow-up time ranged from 12 to 45 months.The average ALP value was（65.0±5.3）,（69.1±8.9）,（58.4±12.2）mmol/L at 6 weeks,3 month and 1 year respectively.Two patients were diagnosed as ossifying myositis.A total of 69 patients gained the follow-up in control group,ranging from 12 to 65 months.The average ALP value was（97.6±29.3）,（73.3±11.1）,（62.5±15.3）mmol/L at 6 weeks,3 month and 1 year postoperatively respectively.Seven patients were diagnosed as ossifying myositis.Significant difference was demonstrated in ALP at 6 weeks postoperatively,while no significant differences of ALP at 3 months or 1 year postoperatively.The incidence of ossifying myositis was much higher in control group.Conclusion Postoperative NSAID treatment for patients with elbow trauma can prevent the occurrence of ossifying myositis efficiently.