门诊骨关节炎患者86例诊治总结.DOCVIP

临床医学论文-门诊骨关节炎患者86例诊治总结 【摘要】? 目的? 探讨门诊骨关节炎病人的临床特点及早期治疗疗效。方法? 自2004年1月～2005年9月在我院外科门诊就诊的86例确诊骨关节炎病人，收集其完整的临床资料，进行回顾性分析总结。诊断标准采用“美国手、膝关节骨关节炎的诊断标准”和“骨性关节炎放射X线Kellgren ＆ Lawrence分级”。所有病人都进行了骨关节炎疾病宣传教育，物理治疗，非甾体消炎镇痛药物治疗。随访1～20个月（平均11.3个月），治疗前后疼痛症状的改善作为疗效判定标准，使用VAS评分系统（百分制）。改善≥80％为优，改善≥50%～80％为良，改善≤20％为差。结果? 86例骨关节炎病人多发生于60岁以上的老年人，占69.8%，女性多于男性。发病部位本组多见于膝关节，其他依次为脊柱关节、踝关节、手指关节和髋关节。关节疼痛是本组病人共有的主要症状；晨僵，关节功能受限，骨质增生性结节，关节肿胀、畸形，肥胖是本组病例的主要临床表现。患者通过早期综合治疗和预防宣教，73例改善优良，7例病情控制没有出现加重的情况。6例临床症状无好转。结论? 门诊骨关节炎病人，根据其特有的临床特点能够及时做出诊断，并在早期进行治疗和宣教，能够得到较好的疗效。??? ??? 【关键词】? 骨关节炎；临床特点；门诊病人；诊断；治疗??????????? 【Abstract】? Objective? To describe the clinical characteristic， and to evaluate primary diagnosis and treatment of patients with osteoarthritis in outpatient.Methods? Using data from January 2004 to September 2005， the clinical characteristic and early treatment of 86 patients with osteoarthritis in outpatient have been reviewed， include patients gender， age， all of clinical symptoms，X-rays and so on. The diagnostic standard of osteoarthritis used with criterion of U.S.A. Method of early treatment was NSAID， standard health teaching and physical treatment.Results? Elderly people represented 69.8% of the sample； mean age was 71.2 years. Two third of patients had OA of the knee， 11.6% of the spine， and 10.5% of the ankle； 8.1% had other joint OA. Women with OA are more than men. The main clinical symptoms are pain of joint， morning stiffness， limited joint function， Heberdens nod， deformity and swelling of joint and obesity in these cases. All of 86 OA cases received early treatment， 73 cases get better for their state of illness， 7 cases get a stable control， 6 aged cases were worsened because of their other disease， their clinical symptoms didnt get relief.Conclusion? Osteoarthritis is easy to diagnose according to the main clinical symptoms and characteristic of patients in outpatient. Early treatment and health teaching could get effective and good results.??? ??? 【Key words】? osteo