胸腔镜联合内固定术治疗多发性肋骨骨折的效果分析

Effect of thoracoscopy combined with internal fixation in the treatment of multiple rib fractures

目的:探讨胸腔镜联合内固定术治疗多发性肋骨骨折的临床疗效。方法:回顾性分析28例多发性肋骨骨折病人的临床资料,按照治疗方式分成手术组与保守治疗组,每组14例。观察2组治疗前后疼痛视觉模拟评分(VAS)、卧床时间、住院时间及并发症发生情况。结果:治疗后2组VAS评分逐渐降低,且手术组治疗后24 h、48 h、72 h的VAS评分均低于保守治疗组(P<0.05~P<0.01)。手术组卧床时间及住院时间显著短于保守治疗组(P<0.01)。随访6个月,手术组无相关并发症发生,保守治疗组出现6例并发症,其中4例因胸腔积液行胸腔闭式引流术,2例严重胸廓畸形伴顽固性胸痛,并发症发生率为42.9%。结论:胸腔镜联合内固定术治疗多发性肋骨骨折较保守治疗能够加快康复速度,缩短住院时间、减轻疼痛及降低并发症发生率,值得临床推广。

Objective： To investigate the clinical efficacy of thoracoscopy combined with internal fixation in the treatment of multiple rib fractures. Methods： The clinical data of 28 patients with multiple rib fractures were retrospectively analyzed,and the patients were divided into the surgical treatment group and conservative treatment group according to the therapy method（ 14 cases each group）. The visual analog scale（ VAS） score,time in bed,length of hospital stay and complications in two groups before and after treatment were recorded. Results： The VAS scores in two groups after treatment gradually decreased,and the VAS scores in surgical treatment group after 24 h,48 h and 72 h of treatment were lower than that in conservative treatment group（ P〈0. 05 to P〈0. 01）. The time in bed and length of hospital stay in surgical treatment group were significantly shorter than those in conservative treatment group,respectively（ P〈0. 01）. During the 6 months of following up,6 cases with complications in conservative treatment group were found,4 cases with pleural effusion were treated with closed drainage of pleural cavity,2 cases were severe thoracic deformity complicated with refractory chest pain,and the incidence rate of complication was 42. 9%. No complication occurred in surgical treatment group. Conclusions： The thoracoscopy combined with internal fixation in the treatment of multiple rib fractures can shorten the recovery time,reduce the duration of hospital stay,relieve pain and reduce complications of patients,which is worthy of promotion in clinic.