胸腔镜在多发肋骨骨折切开复位内固定术中的应用价值

Application value of Video-assisted thoracoscopy in open reduction and internal fixation of fracture of multiple ribs

目的探讨胸腔镜在多发肋骨骨折切开复位内固定术中的应用价值。方法回顾性分析40例多发肋骨骨折患者的临床资料,比较胸腔镜下(对照组)与传统开胸镍钛记忆合金环抱器内固定(观察组)治疗多发肋骨骨折患者的术后疼痛评分,肺炎、肺不张发生情况,住院天数,肺活量及胸腔闭式引流拔管时间。结果入院时两组疼痛评分比较,差异无统计学意义(P>0.05),术后观察组疼痛评分,肺炎、肺不张发生率,住院天数,胸腔闭式引流管拔管时间低于或少于对照组,差异有统计学意义(P<0.05);术前两组肺活量比较,差异无统计学意义(P>0.05),术后肺活量观察组比对照组明显改善,差异有统计学意义(P<0.05)。结论胸腔镜下镍钛记忆合金环抱器内固定术治疗多发肋骨骨折安全、可靠,可减轻疼痛,缩短住院天数,减少术后并发症发生率,有利于改善肺功能,加快患者康复,值得临床推广应用。

Objective To explore the application value of Video-assisted thoracoscopy in open reduction and internal fixation of fracture of multiple ribs.Methods Relevant data of 40 patients were reviewed.Comparisons were made on the postoperative pain intensity,the occurrence of pneumonia and pulmonary atelectasis,the hospitalization time,vital capacity and the extubation time of closed thoracic drainage tube between the nickel titanium memory alloy embracing fixator in the treatment of multiple rib fractures by video-assisted thoracoscope（the treatment group）and traditional treatment（the control group）.ResultsAt admission,the pain scores had no significant difference between the treatment group and the control group（P〈0.05）.The postoperative pain intensity,the occurrence of pneumonia and pulmonary atelectasis,the hospitalization time,vital capacity and the extubation time of closed thoracic drainage tube of the treatment group was significantly lower than those of the control group after operation（P〈0.05）.Before operation,the vital capacity of the treatment group was not significantly different from the control group（P〈0.05）.The postoperative vital capacity in the treatment group was significantly different than that in the control group（P〈0.05）.Conclusion Nickel titanium memory alloy embracing fixator in thoracoscopic surgery for the treatment of multiple rib fractures is safe and reliable.It can alleviate pain,shorten hospital stay,reduce the incidence of postoperative complications,improve lung function and accelerate the rehabilitation of patients.It is worthy of clinical application.