CAJ | 학술논문

目的探讨关节镜清理配合运动疗法及运动疗法治疗老年骨关节炎的效果.方法将210例老年膝关节骨关节炎患者按随机数字表法分为手术组和非手术组,每组105例,手术组给予关节镜清理,术后配合运动疗法治疗,非手术组给予单纯运动疗法治疗.治疗前及治疗后1、6、12个月应用视觉模拟评分(VAS)及国际膝关节文献委员会膝关节评估表(IKDC)评分进行评定并比较.结果 210例患者均进入结果分析,无脱落.手术组及非手术组治疗前、治疗后6和12个月VAS、IKDC评分比较差异无统计学意义(P＞0.05);手术组治疗后1、6和12个月VAS、IKDC评分较治疗前显著改善,差异有统计学意义(P＜0.05);非手术组治疗后6和12个月VAS、IKDC评分较治疗前显著改善,差异有统计学意义(P＜0.05).根据IKDC评分,手术组治疗后优15例,良61例,中19例,差10例,优良率为72.38％(76/105);非手术组优14例,良59例,中20例,差12例,优良率为69.52％(73/105).两组优良率比较差异无统计学意义(P＞0.05).结论指导下运动疗法可以明显改善老年膝关节骨关节炎患者的关节功能,缓解关节疼痛症状.关节镜清理治疗可以快速减轻关节急性炎性症状,但对骨关节炎中、远期的治疗无明显临床意义.
목적 탐토관절경청리배합운동요법급운동요법치료노년골관절염적효과.방법 장210례노년슬관절골관절염환자안수궤수자표법분위수술조화비수술조,매조105례,수술조급여관절경청리,술후배합운동요법치료,비수술조급여단순운동요법치료.치료전급치료후1、6、12개월응용시각모의평분(VAS)급국제슬관절문헌위원회슬관절평고표(IKDC)평분진행평정병비교.결과 210례환자균진입결과분석,무탈락.수술조급비수술조치료전、치료후6화12개월VAS、IKDC평분비교차이무통계학의의(P＞0.05);수술조치료후1、6화12개월VAS、IKDC평분교치료전현저개선,차이유통계학의의(P＜0.05);비수술조치료후6화12개월VAS、IKDC평분교치료전현저개선,차이유통계학의의(P＜0.05).근거IKDC평분,수술조치료후우15례,량61례,중19례,차10례,우량솔위72.38％(76/105);비수술조우14례,량59례,중20례,차12례,우량솔위69.52％(73/105).량조우량솔비교차이무통계학의의(P＞0.05).결론 지도하운동요법가이명현개선노년슬관절골관절염환자적관절공능,완해관절동통증상.관절경청리치료가이쾌속감경관절급성염성증상,단대골관절염중、원기적치료무명현림상의의.
Objective To discuss the effectiveness between arthroscope cleaning combined with exercise therapy and exercise therapy in senile osteoarthritis patients.Methods Two hundred and ten senile osteoarthritis patients were divided into operation group and non-operation group by random digits table method with 105 cases each.Patients in operation group received the arthroscope cleaning and exercise therapy,and patients in non-operation group received the exercise therapy alone.The visual analogue score (VAS) and international knee documentation committee knee evaluation form (IKDC) score before treatment and 1,6 and 12 months after treatment were compared.Results A total of 210 patients received the analysis of result without drop-out.There were no statistical differences in VAS and IKDC scores before treatment and 6 and 12 months after treatment between operation group and non-operation group (P ＞ 0.05).The VAS and IKDC scores 1,6,12 months after treatment were significantly improved compared with those before treatment in operation group,and there were statistical differences (P ＜ 0.05).The VAS and IKDC scores 6,12 months after treatment were significantly improved compared with those before treatment in non-operation group,and there were statistical differences (P ＜ 0.05).According to the IKDC score,in operation group 15 patients were excellent,61 patients were fine,19 patients were general and 10 patients were bad after treatment,and good effectiveness rate was 72.38％ (76/105).In non-operation group,14 patients were excellent,59 patients were fine,20 patients were general and 12 patients were bad after treatment,and good effectiveness rate was 69.52％ (73/105).There was no statistical difference in the good effectiveness rate between 2 groups (P ＞ 0.05).Conclusions Exercise therapy with guidance can significantly improve the function of senile knee joint osteoarthritis,and ease joint pain symptoms.Arthroscope cleaning combined with exercise therapy can relieve the joint acute inflammatory symptoms,but it has no significant clinical effectiveness in long-term treatment of osteoarthritis.