美洛昔康与吲哚美辛防治全髋关节置换后异位骨化的比较(英文)

Meloxicam versus indomethacin in the prevention of heterotopic ossification after total hip arthroplasty

背景:为了避免全髋关节置换后发生异位骨化,常使用吲哚美辛等非类固醇类消炎药进行预防治疗。目的:对比观察美洛昔康与吲哚美辛对全髋关节置换后预防异位骨化药物的效果。方法:收集2010至2011年广州中医药大学第一附属医院骨科收治的51例患者,其中9例患者行双侧全髋关节置换,所有患者均由同一位医师采用后外侧入路进行关节置换。根据患者置换后使用的药物不同,分为对照组及实验组,分别在置换后口服吲哚美辛缓释片25 mg/d+奥美拉唑肠溶胶囊20 mg/d或美洛昔康片15 mg/d。结果与结论:单独使用美洛昔康和使用吲哚美辛+奥美拉唑对关节置换患者异位骨化的发生率、疼痛、改良D'Aubigne和Postel评分的差异均无显著性意义(P>0.05),但美洛昔康的胃肠道不良反应较少。因此,认为单独服用美洛昔康能够有效避免异位骨化的发生及缓解疼痛,可以作为预防全髋关节置换后异位骨化及疼痛的推荐用药。

BACKGROUND：In order to avoid heterotopic ossification after total hip arthroplasty, nonsteroidal anti-inflammatory drugs are commonly used for prevention. OBJECTIVE：To compare the effect of meloxicam and indomethacin in the prevention of heterotopic ossification after total hip arthroplasty. METHODS：Fifty-one patients who treated in the Department of Orthopedics, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from 2010 to 2011 were col ected. Among the 51 patients, nine patients were treated with bilateral total hip arthroplasty, and al the patients had total hip arthroplasty with the posterior-lateral approach. The patients were divided into the control group and the experimental group according to the drugs used after replacement, and the patients in the two groups were administered with indomethacin sustained-release tablet 25 mg＋omeprazole capsule 20 mg or meloxicam tablet 15 mg after replacement. RESULTS AND CONCLUSION：There were no significant differences in the incidence of heterotopic ossification, pain, modified D’Aubigne and Postel scores after replacement between two groups （P〉0.05）. But, the gastrointestinal adverse reactions of the experimental group were less than those of the control group. The application of meloxicam only can effectively avoid the heterotopic ossification and release pain. Consequently, we recommend meloxicam as postoperative drug for the prevention of heterotopic ossification and pain remission fol owing total hip arthroplasty.