VAMT肋骨内固定联合术后静脉镇痛治疗连枷胸

Treatment of Flail Chest by Internal Fixation of Ribs with Video-Assisted Mini Thoracotomy Together with Postoperative Patient Controlled Intravenous Analgesia

目的探讨电视胸腔镜辅助小切口(VAMT)可吸收钉肋骨内固定术联合术后持续静脉镇痛治疗连枷胸的临床疗效,总结连枷胸的治疗经验。方法分析揭阳市人民医院2008年3月-2011年6月期间接受电视胸腔镜辅助小切口可吸收钉肋骨内固定术联合术后静脉镇痛治疗的76例连枷胸患者的临床资料。结果全组病例无死亡,手术时间平均50 min,术后平均住院12.5 d,胸廓塌陷纠正率97%,疼痛明显减轻率93%。结论胸腔镜辅助下可吸收钉肋骨内固定术联合术后持续静脉镇痛治疗连枷胸,手术微创,使患者病情迅速好转,疗程短,并发症少,治愈率高,保持胸廓容积和美观,疗效明显优于非手术治疗,同时避免二次手术,是一种治疗连枷胸的理想方法。

Objective To investigate the clinical effect of internal fixation of ribs with video-assisted mini thoracotomy using absorbable screw together with postoperative patient controlled intravenous analgesia on the flail chest,and summarize the experience of treatment of flail chest.Methods A retrospectively analysis on clinical data of 76 cases of flail chest by internal fixation of ribs with video-assisted mini thoracotomy using absorbable screw together with postoperative patient controlled intravenous analgesia,which were performed from March 2008 to June 2011,was made.Results No death occurred.The operation time was 50 minutes.The average postoperative hospitalization was 12.5 d.The thoracic coolapse correcting rate was 97%.The ache significantly alleviating rate was 93%.Conclusion Treatment of flail chest by thoracoscopy-assisted internal fixation of ribs with absorbable screw together with postoperative patient controlled intravenous analgesia has the advantage of mini incision,rapid progress,short time of therapy,complication decrease,high recovery rate,keep the thoracic capacity and beauty,is much better than that of non-operative fixation,and avoid further surgery,is an ideal method for flail chest.