「內外科護理學-骨科護理」退化性膝關節炎的常見臨床表現與護理Common clinical manifestations and nursing care of osteoarthritis of the knee

退化性關節炎Osteoarthritis (OA)

是一種常見的慢性關節疾病，隨著年齡增長，關節軟骨逐漸磨損，導致關節疼痛、僵硬、腫脹等症狀。膝關節是常見的受累部位，屬於骨科常見疾病。

Osteoarthritis (OA) is a common chronic degenerative joint disease characterized by the breakdown of cartilage in the joints. The knee is a frequently affected joint. As cartilage wears down, it can cause pain, stiffness, and swelling.

臨床表現Clinical Manifestations

疼痛： 常見於活動時，尤其是在負重或上下樓梯時。休息後疼痛可緩解。

Pain: Often occurs with activity, especially weight-bearing activities or climbing stairs. Pain may subside with rest.

僵硬： 早晨起床或長時間靜止後，關節會感到僵硬，活動後可緩解。

Stiffness: Stiffness is common upon waking or after prolonged periods of inactivity. It usually improves with movement.

腫脹： 關節周圍可能出現輕微腫脹。

Swelling: Mild swelling may occur around the joint.

變形： 隨著病情進展，關節可能出現O型腿或X型腿的變形。

Deformity: Over time, the joint may become deformed, leading to bowlegs or knock-knees.

功能障礙： 影響日常生活活動，如行走、爬樓梯、蹲下等。

Functional impairment: Daily activities such as walking, climbing stairs, and squatting may become difficult.

關節摩擦音： 活動關節時，可能聽到或感覺到關節內有摩擦聲、輾軋音。

Crepitus: A grating or crunching sensation may be felt or heard when moving the joint.

有關退化性關節炎此類病人的護理措施
Regarding nursing care for patients with osteoarthritis:

鼓勵進行等張運動，如騎腳踏車或游泳，這種運動形式能讓肌肉收縮但關節角度不變，對退化性關節炎患者來說，可以增強肌肉力量，穩定關節，減少關節的壓力，有助於緩解疼痛和改善功能。且若有僵硬情形，進行熱敷可以改善。

Encouraging isometric exercises such as cycling or swimming is highly recommended. These types of exercises involve muscle contraction without joint movement, helping to strengthen muscles, stabilize joints, and reduce joint stress in osteoarthritis patients. This can effectively alleviate pain and improve overall function. Additionally, applying heat therapy can help alleviate stiffness.

另外補充項目：
Additional Notes:

Plaquenil 主要用於治療類風濕性關節炎，而非退化性關節炎。

Plaquenil is primarily used to treat rheumatoid arthritis, not osteoarthritis.

限制嘌呤(如內臟類、肉汁)攝取主要針對痛風患者，而非退化性關節炎患者。

Limiting purine intake (e.g., organ meats, meat broth) is primarily for gout patients, not osteoarthritis patients.

對於退化性關節炎患者來說，鼓勵進行等張運動是最適合的護理措施。這類運動能有效地增強肌肉力量，穩定關節，減輕疼痛，改善患者的生活品質。

For osteoarthritis patients, encouraging isometric exercises is the most suitable nursing intervention. These exercises effectively strengthen muscles, stabilize joints, reduce pain, and improve quality of life.

退化性膝關節炎的護理重點在於控制疼痛、維持關節功能、教育患者，並提供心理支持。護理人員應根據患者的病情和需求，制定個性化的護理計劃，幫助患者提高生活品質。

Nursing care for patients with osteoarthritis of the knee focuses on pain management, preserving joint function, patient education, and providing emotional support. Nurses play a vital role in helping patients manage their condition and improve their quality of life.