中文摘要：

目的 比较布洛芬、塞来昔布及氟吡洛芬对肩袖修复术后的止痛效果、安全性以及对肩袖愈合的影响.方法 2012年12月至2013年12月,北京积水潭医院运动损伤科选择肩袖修复术患者63例.患者术后数字表法随机分为氟比洛芬、布洛芬及塞来昔布组,每组21例,治疗5d.采用疼痛视觉模拟评分（VAS）评估患者术后疼痛情况并进行组间比较,观察不良反应并进行组间对比.术后1年进行疼痛评分,肩关节功能评分,前屈上举、体侧外旋、内旋活动范围,与术前进行对比并进行组间比较.结果 3组患者术后疼痛逐步缓解,术后第4天开始氟吡洛芬酯组疼痛评分明显低于另两组（第4天静止相P =0.03,活动相P=0.04;第5天静止相与活动相均P=0.03）;药物不良反应发生率依次为布洛芬33.3％,塞来昔布14.3％,氟吡洛芬酯9.5％,3组间差异无统计学意义（P＞0.05）.患者术前VAS平均7.2,肩关节简单评分（SST）为6.5,评估肩关节功能评分（Constant-Murley）为67.6,加州大学洛杉矶评分（UCLA）为17;前屈上举132.6°,外旋37.7°,内旋达L1水平;术后1年时VAS在布洛芬、塞来昔布及氟吡洛芬酯组依次为2.0、2.1、1.9;SST分别为9.2、8.5、10.5;Constant分别为82.7,91.2,90.5;UCLA分别为29.9、33.2、30.3;前屈上举3组分别为151.2°、150.0°、160.3°;,外旋依次为49.2°、50.7°、56.7°;;内旋分别为T12、T12及T8水平.疼痛、活动度及功能评分均较术前有明显改善,3组间差异无统计学意义（P＞0.05）.结论 非甾体类消炎药可应用于肩袖修复术后早期的疼痛控制,不影响肩袖肌腱的愈合;氟吡洛芬酯的效果优于布洛芬和塞来昔布.

英文摘要：

Objective To compare the effectiveness and safety of ibuprofen,celecoxib and flurbiprofen axetil after arthroscopic rotator cuff repair.Methods From Dec.,2012 to Dec.,2012,63 arthroscopy rotator cuff repaired patients in Department of Orthopedics＆amp;Traumatology,Beijing Jishuitan Hospital,were selected and divided randomized into 3 groups：flurbiprofen axetil,ibuprofen and celecoxib.Each group had 21 patients.All groups take drugs 5 days continuously after operation.In first five days postoperatively,visual analogue scale （VAS） was used to compare pain alleviation.The side effects were assessed among three groups.VAS,Shoulder evaluation functional score,range of shoulder forward elevation,external rotation and internal rotation were recorded,compared between the same patients preoperatively and postoperatively and compared also among three groups.Results Pain was relieved postoperatively with time being in all patients.From 4 day postoperatively,flurbiprofen axetil showed significant difference on pain relieving compared with ibuprofen and celecoxib （P 〈 0.05）.Side effects of ibuprofen,celecoxib and flurbiprofen axetil was 33.3%,14.3% and 9.5% separately.No significant difference was found among three groups.Preoperatively,VAS =7.2,SST =6.5,Constant =67.6,UCLA =17;FE =132.6°,ER =37.7°,IR =L1on average.One year postoperatively,in ibuprofen,celecoxib and flurbiprofen axetil group,VAS was 2.0,2.1,1.9;SST was 9.2,8.5,10.5;Constant was 82.7,91.2,90.5;UCLA was 29.9,33.2,30.3;FE was 151.2°,150.0°,160.3°,ER was 49.2°,50.7°,56.7°;IR was ip to T12,T12,T8 level separately.All patients showed significant improvement on VAS,function evaluation score and range of motion one year postoperatively and no significant difference were found among three groups.Conclusion Flurbiprofen axetil showed better result compared with ibuprofen and celecoxib on pain control,although all three COX inhibitors are highly-efficient and safe for rotator cuff repaired patients.Thereis no significant difference among three group