手术和非手术治疗在老年膝骨性关节炎患者中临床应用比较.docVIP

手术和非手术治疗在老年膝骨性关节炎患者中临床应用比较 　　[摘要] 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（P0.05）。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。 　　[关键词] 膝骨性关节炎；VAS评分；WOMAC指数；HSS评分；SF-12评分；老年 　　[中图分类号] R284 [文献标识码] A [文章编号] 1674-0742（2015）08（b）-0064-02 　　[Abstract] 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， pharmacotherapy， 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 according to X-ray， non-operative treatment was superior to operative treatment in the improvement of symptoms and patients’ satisfaction， 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’ satisfaction， but the differences were not statistically significant， P0.05. Conclusion For the elderly patients with knee osteoarthritis， we should choose appropriate treatment methods according to different staging and individual situation of the patients. 　　[Key words] Knee osteoarthritis；