同期双侧胸腔镜联合肋骨接骨板内固定治疗双侧多发肋骨骨折的体会

The Experience of that Synchronized Bilateral Video-assisted Thoracic Surgery Combine Rib Plates internal Fixation to Treat Bilateral Multi-Rib-Fracture

目的:探讨同期双侧胸腔镜联合肋骨接骨板内固定治疗双侧多发肋骨骨折的方法及临床疗效评价。方法:对13例双侧多发肋骨骨折患者施行同期双侧胸腔镜联合肋骨接骨板内固定治疗,对于合并胸内损伤有胸腔探查指征者,先手术治疗损伤重的一侧;对于肋骨固定为主者,先手术治疗损伤较轻的一侧。固定材料选用形状记忆环抱接骨板。结果:全组13例患者均临床治愈,术后双侧胸痛明显缓解,胸廓畸形纠正,缩短ICU治疗时间,无明显并发症发生。结论:双侧多发肋骨骨折行同期双侧胸腔镜联合肋骨接骨板内固定治疗,能有效恢复胸廓的完整性,减少并发症,改善预后,而且具有创伤小的优点。

Objective： Explore the method and clinical therapeutic efficacy that synchronized bilateral video-assisted thoracic surgery combine rib plates internal fixation to treat bilateral multi-rib-fracture.Methods： 13 cases which suffer bilateral multi-rib-fracture were treated by bilateral video-assisted thoracic surgery combine rib plates internal fixation,if suffer the damage inside chest that fit to the indication of the exploratory thoracotomy,we do treat the worse side first;if suffer rib-fracture only,we treat the side first that not suffer so bad.We used shape memory encircle rib plates in operation as fixer material.Results： The 13 cases were all cured.Further-more,after operation,their chest pains were released obviously,their thoracocyllosis was rectified,the time they treated in ICU was re-duced,and no severe complication suffer to them.Conclusion： Synchronized bilateral video-assisted thoracic surgery combine rib plates internal fixation to treat bilateral multi-rib-fracture that can recover chest integrity effectively,reduce the complication,improve the prog-nosis.Furthermore,it has superiority of microtrauma.