单孔胸腔镜联合环抱式接骨板治疗多根多处肋骨骨折的临床疗效观察

Clinical effect of single hole thoracoscope combined with encircling bone plate for treatment of multiple rib fractures

目的观察单孔胸腔镜联合环抱式接骨板治疗多根多处肋骨骨折的临床疗效。方法回顾陕西中医药大学附属医院胸心外科收治的54例多根多处肋骨骨折患者,依据是否手术分为观察组(n=25)和对照组(n=29)。观察组采用单孔胸腔镜联合环抱式接骨板内固定治疗,对照组采用胸部护板外固定与加压包扎保守治疗。观察两组患者的临床疗效、治疗指标及并发症。结果观察组患者术后下床活动时间、住院时间、骨折愈合时间均显著短于对照组,差异有统计学意义(P <0.05),但两组患者的视觉模拟评分法(VAS)疼痛评分比较差异无统计学意义(P>0.05)。观察组术后并发症发生率为28.0%;对照组术后并发症发生率为55.2%,观察组明显低于对照组(χ~2=15.195,P<0.01)。观察组临床疗效总优良率为84.0%,对照组临床疗效总优良率为69.0%,观察组显著优于对照组(χ~2=6.280,P<0.05)。结论采用单孔胸腔镜联合环抱式接骨板切开复位内固定术治疗多根多处肋骨骨折临床效果好,且具有恢复快、并发症少等优点。

Objective To investigate the clinical efficacy of single hole thoracoscopic surgery combined with circumferential bone graft plate for the treatment of multiple rib fractures.Methods 54 patients with multiple rib fractures who were admitted to the Department of Cardiovascular Surgery in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine were divided into the observation group （ n =25） and the control group （ n =29） according to whether receiving surgery or not. The observation group was treated with single hole thoracoscopic surgery and encircling bone plate fixation, and the control group received chest shield external fixation and compression dressing conservative treatment. The clinical efficacy, treatment indicators and complications were observed for the two groups.Results There were significant differences in the time of ambulation, hospital stay and fracture healing time between the two groups （ P 〈0.05）. There was no significant difference in visual analogue scale（VAS） pain scores （ P 〉0.05）. The total incidence of complications in the observation group and in the control group was 28.0% and 55.2% respectively, which showed a significant difference （χ 2=15.195, P 〈0.01）. The good rate was 84.0% in the observation group and 69.0% in the control group. The clinical efficacy of the observation group was better than that of the control group, and the difference was statistically significant （χ 2=6.280, P 〈0.05）.Conclusions The utilization of single-hole thoracoscopic surgery combined with oscillating plate osteotomy for the treatment of multiple rib fractures has the advantages of good clinical outcome, quick recovery, and few complications.