胸腔镜辅助下对重度胸部创伤病人治疗效果的分析

Analysis on the effect of VATS for patients with severe chest trauma

目的利用电视胸腔镜辅助下对胸部创伤病人进行早期手术,探讨其临床效果。方法我院2011年5月-2014年5月收治的重度胸部创伤病人76例采用电视胸腔镜辅助下手术,另以同期开胸手术患者30例为对照,比较两组术式手术时间、术中出血量、住院时间、术后VAS评分、并发症、术前及术后24 h炎症因子变化。结果与对照组相比,实验组手术时间短,术中出血量少,术后VAS评分低,差异具有统计学意义(P<0.05);实验组术后复发率高于对照组但差异无统计学意义(P>0.05);与对照组相比,实验组住院时间、下床活动时间、恢复日常活动时间更短,术后24 h引流液更少,差异具有统计学意义(P<0.05);与术前相比,术后24 h两组炎症因子均明显增加(P<0.05),但实验组增加程度低于对照组,差异具有统计学意义(P<0.05)。结论电视胸腔镜对胸部创伤刺激小,术后恢复快,具有较好治疗效果。

Objective To explore the effect of early operation on chest trauma patients under VATS. Methods 75 patients with severe chest trauma from May, 2012 to May, 2014 were given video-assisted thoraeoscopic operation, and another 30 patients were treated with open chest operation at the same period as the control group. The following items were compared between the two groups, surgical operation time, amount of bleeding, duration of hos- pital stay, postoperative VAS score, complications, and changes of inflammatory cytokines preoperative and 24h after the operation. Results Compared with the control group, the experiment group had shorter operation time, less bleeding, and lower postoperative VAS score （ P 〈 0.05 ）. The recurrence was slightly higher in the experimental group than in the control group （ P 〉 0.05 ）. The experiment group had shorter duration of hospital stay and ambulation time for recovery of daily activities than the control group did, and the postoperative drainage was less in the experiment group than in the control group （ P 〈 0. 05 ）. The level of inflammatory cytokines increased significantly in the two group postoperative （ P 〈 0. 05 ） , but the increase was more pronounced in the control group than in the experiment group （ P 〈 0. 05 ）. Conclusion VATS has the advantages of little chest trauma, quick postoperative recovery, and good curative effect.