CAJ | 학술논문

目的：探讨手术和非手术方法在治疗膝骨性关节炎的疗效差异。方法随机选取2011年1月—2014年1月该院骨科收治的膝骨性关节炎患者120例，随机分为手术组和非手术组，每组60例。手术组均采用关节镜下的微创手术治疗，非手术组采用饮食、功能锻炼、药物、针灸等非手术治疗，观察治疗前及治疗后1月两组患者在症状及生活质量改善的差异。结果对于年龄大于73岁高龄患者以及轻度及I-Ⅱ级的OA患者，非手术治疗在症状改善以及患者满意度方面，均高于手术治疗的患者，两者差异有统计学意义(P<0.05)；而对于中重症以及Ⅲ~Ⅳ级的老年患者，手术组在症状改善以及患者满意度优于非手术治疗组，但两组差异无统计学意义(P>0.05)。结论对于老年膝骨性关节炎患者，应根据OA的不同分期以及患者的个体情况，选择不同的治疗方式。
목적：탐토수술화비수술방법재치료슬골성관절염적료효차이。방법수궤선취2011년1월—2014년1월해원골과수치적슬골성관절염환자120례，수궤분위수술조화비수술조，매조60례。수술조균채용관절경하적미창수술치료，비수술조채용음식、공능단련、약물、침구등비수술치료，관찰치료전급치료후1월량조환자재증상급생활질량개선적차이。결과대우년령대우73세고령환자이급경도급I-Ⅱ급적OA환자，비수술치료재증상개선이급환자만의도방면，균고우수술치료적환자，량자차이유통계학의의(P<0.05)；이대우중중증이급Ⅲ~Ⅳ급적노년환자，수술조재증상개선이급환자만의도우우비수술치료조，단량조차이무통계학의의(P>0.05)。결론대우노년슬골성관절염환자，응근거OA적불동분기이급환자적개체정황，선택불동적치료방식。
Objective To observe the difference of effect between operative and non-operative treatment for knee osteoarthritis. Methods 120 elderly patients with knee osteoarthritis (OA) were collected from January 2011 to January 2014 in my department, and were randomly divided into operation group (60 cases) and non-operation group (60 cases). In the operation group all patients were treated with arthroscopic surgery, while in the non-operation group they received diet therapy, kinesitherapy, pharmacothera-py, acupuncture and moxibustion therapy, naturopathy and other non-operative treatment. VAS score, WOMAC index, HSS score and SF-12 score were applied to observe the differences in the improvement of symptoms and quality of life between the two groups. Results After treatment, for the patients who were older than 73 years, were with mild OA and were in grade I~II accord-ing to X-ray, non-operative treatment was superior to operative treatment in the improvement of symptoms and patients’ satisfac-tion, and the differences were statistically significant; while for the elderly patients who were with moderate or sever OA, and were in grade III~IV, operative treatment was superior to non-operative treatment in the improvement of symptoms and patients’ satis-faction, but the differences were not statistically significant, P>0.05. Conclusion For the elderly patients with knee osteoarthritis, we should choose appropriate treatment methods according to different staging and individual situation of the patients.