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[目的]评价全髋关节置换术(total hip arthroplasty,THA)后单次小剂量应用地塞米松对缓解术后疼痛的安全性及有效性.[方法]将2016年5月～2016年8月收治的拟行初次单侧全髋关节置换术的患者110例随机分为两组,地米组术后1～2 h静脉注射10 mg地塞米松;安慰组围术期不应用地塞米松.搜集并比较两组患者术前及术后静息及活动状态下的VAS评分、术后应用镇痛药物的例数及应用剂量、炎性因子[C-反应蛋白(CRP)、白细胞介素-6 (IL-6)]水平、住院时间、关节活动度、感染及胃肠道出血事件的发生率.[结果]地米组术后24、48 h活动状态下的VAS评分明显低于安慰组,且在镇痛药物的使用方面也有了一定的减少,其差异具有统计学意义(P＜0.05).地米组术后24、48及72 h的IL-6水平均低于安慰组(P＜0.001),而术后48、72 h的CRP水平亦低于安慰组(P＜0.001).地米组的住院时间相比于安慰组有了明显的缩短(P=0.003),并在出院前拥有较好的关节活动度(P＜0.001).整个住院及随访期间没有发生感染及胃肠道出血事件.[结论]术后单次静脉应用10 mg地塞米松能够有效缓解全髋关节置换术后疼痛,减少对镇痛药物的使用,降低术后炎性因子水平,缩短住院时间,增加关节活动度,且不增加感染及胃肠道出血的风险.“,”[Objective] To evaluate the effect and safety of a single low-dose postoperative dexamethasone (DX) on pain following total hip arthroplasty (THA).[Methods] From May 2016 to August 2016,110 patients who underwent THA were randomly divided into the DX group and placebo group.At lh-2h postoperatively,the patients in the DX group received a single dose of 10 mg DX intravenously,while those in the placebo group were given the same amount of normal saline.The pain intensity at rest and during mobilization,consumption of analgesic,inflammatory factors,hospital stay,range of motion,and adverse reaction were carefully recorded and compared.[Results] At 24 h and 48h after operation,the DX group was scored significantly lower dynamic VAS,associated with less consumption of analgesic compared with the placebo group (P＜0.05).In term of inflammatory factors,the C-reaction protein (CPR) in the DX group proved siguificantly lower than the placebo group at 48,72 h after operation (P＞0.05),similarly,the interleukin 6 (IL-6) in the DX group was considerably lower than the placebo group at 24,48 and 72 h postoperatively (P＞0.05).In addition,patients in the DX group had significantly shortened hospital stay (P=0.003),with improved ROM before discharge (P＜0.001) over the placebo group.No incision infection or gastrointestinal hemorrhage was noted in any patient of both groups.[Conclusion] Single low-dose dexamethasone postoperatively does enhance pain control,reduce the postoperative level of CRP and IL6,shorten hospital stay,and improve mobility of the affected hip following total hip arthroplasty without increasing the risk of infection and gastrointestinal hemorrhage.