台灣退化性膝關節炎長者玻尿酸注射治療後復健資源使用之探討

Change of Rehabilitation Utilization after Intra-articular Hyaluronic Acid Injections in the Elderly with Degenerative Knee Osteoarthritis in Taiwan

謝嘉娟(Chia-Chuan Hsieh) ； 林易申(I-Shen Lin) ； 周稚傑(Chih-Chieh Chou) ； 唐淑貞(Shu-Chen Tang) ； 高森永(Sen-Yeong Kao) ； 羅慶徽(Ching-Hui Loh) ； 高東煒(Tung-Wei Kao)

《中華職業醫學雜誌》 18卷2期 (2011/04) Pp. 93-101

https://doi.org/10.30027/CJOM.201104.0005

摘要

目的：退化性膝關節炎係長者常見疾病，邇近玻尿酸注射為其一治療方式，惟效益迥異；故本文將分析台灣長者退化性膝關節炎之流行病學，並探討玻尿酸關節內注射治療，其前後復健資源使用情形。方法：本研究係以台灣全民健保資料庫，自2002至2006年的特殊需求檔，選取65歲以上長者且具退化性關節炎診斷碼之門診資料，2002年接受玻尿酸關節內注射者，作為研究對象，探討玻尿酸注射與復健治療之消長情形，並比較其人口學各變項、就醫科別及院所層級等之差異。結果：使用玻尿酸注射劑3853人，女性長者罹患退化性關節炎比例較高(67.06%)，就診科別以骨科為最多(71.44%)，就醫院所層級以地區醫院最多(40.02%)，就診人口分布以台北分局最多(32.25%)。研究個案接受玻尿酸關節內注射後，復健次數呈現顯著下降的趨勢。結論：本研究顯示，台灣退化性膝關節炎長者，經玻尿酸注射治療後，復健次數減少，故建議退化性膝關節炎長者及早接受玻尿酸關節內注射治療。

關鍵字

退化性膝關節炎 ； 玻尿酸注射 ； 復健 ； 台灣全民健康保險

並列摘要

Objective: Degenerative knee osteoarthritis (OA) is common in the elderly. Recently, hyaluronic acid (HA) injection is an option, but its effectiveness is not consistent. We investigated the trend of rehabilitation utilization in the elderly with degenerative knee OA receiving intra-articular HA injections in Taiwan.Methods: We analyzed 5-year claim data of Taiwan's National Health Insurance (NHI) from 2002 to 2006. Elderly patients (ages 65 and older) with degenerative knee OA and undergoing injection of intra-articular HA covered by NHI in 2002 were included. The utilization of rehabilitation program was analyzed by descriptive analyses.Results: There were 3853 people included. Elderly women had a higher percentage of degenerative knee OA. Most patients with degenerative knee OA visited orthopedic specialists and had most visits to community hospitals. Most of them were distributed over the Taipei branch. After patients received intra-articular HA treatment, the numbers of rehabilitation programs decreased gradually.Conclusion: The elderly with degenerative knee OA in Taiwan had fewer numbers of rehabilitation programs after injection of intra-articular HA. Therefore, the elderly with degenerative knee OA are recommended to receive intra-articular HA treatment earlier.

並列關鍵字

degenerative knee osteoarthritis ； intra-articular hyaluronic acid ； rehabilitation ； Taiwan's National Health Insurance NHI