快速康复外科在创伤性血气胸中的应用研究

Application Of Rapid Rehabilitation Surgery In Traumatic Hemopneumothorax

目的研究快速康复外科应用于创伤性血气胸患者中的临床价值。方法方便选取该院纳入治疗的60例创伤性血气胸患者实行临床研究,选于2016年5月—2018年11月,按照随机数字表法分组,试验组(n=30)予以快速康复外科干预,对照组(n=30)仅予以胸腔闭式引流干预,分析两组术前、术后24 h、术后72 h呼吸频率及氧合指数(动脉血氧分压/吸入氧浓度),观察两组胸腔积液术前估算量、术前估算量-实际量、拔管前估算量、术前及术后24 h视觉模拟评分法(VAS)评分数值、引流管留置天数、住院天数、住院花费、术后并发症合计率。结果试验组术后24 h、术后72 h呼吸频率低于对照组统计值(20.21±3.10)次/min、(17.20±1.23)次/min vs(23.60±4.14)次/min、(19.12±2.30)次/min,氧合指数高于对照组统计值(313.24±14.90)mmHg/%、(352.60±17.97)mmHg/%vs(261.30±13.87)mmHg/%、(300.58±15.80)mmHg/%,有数值间差异有统计学意义(t=3.590、4.031、14.449、11.907,P<0.05);试验组胸腔积液术前估算量-实际量、拔管前估算量低于对照组统计值(115.40±45.65)mL、(92.67±21.30)mL vs(174.63±54.80)mL、(215.40±34.25)mL,有数值间差异有统计学意义(t=4.548、16.666,P<0.05);试验组术后24 h视觉模拟评分法(VAS)评分数值低于对照组统计值(2.13±0.50)分vs(5.20±0.98)分,有数值间差异有统计学意义(t=15.283,P<0.05);试验组引流管留置天数、住院天数短于对照组统计值(1.41±0.20)d、(3.60±0.45)d vs(3.50±0.46)d、(4.99±0.80)d,住院花费高于对照组统计值(1.20±0.45)万元vs(1.01±0.10)万元,有数值间差异有统计学意义(t=22.821、8.294、2.257,P<0.05);试验组术后并发症合计率低于对照组统计值(3.33%vs 20.00%),有数值间差异有统计学意义(χ^2=4.043,P<0.05)。结论对创伤性血气胸患者采用快速康复外科干预的临床效果较优,展示临床应用价值。

Objective To study the clinical value of rapid rehabilitation surgery in patients with traumatic hemopneumothorax.Methods A total of 60 cases of traumatic hemopneumothorax patients admitted to this hospital from May 2016 to November 2018 in clinical research were convenient selected.According to random number table method,they were divided into experimental group(n=30,with quick healing surgical intervention)and the control group(n=30,with only chest closed drainage intervention.Analyzed 24 h,72 h after preoperative and postoperative respiratory frequency and oxygenation index(arterial blood oxygen partial pressure/inhaled oxygen concentration)of two groups.The preoperative estimated amount,preoperative estimated amount--actual amount,preoperative estimated amount,preoperative and postoperative visual simulation score(VAS)score,days of drainage tube indwelling,days of hospitalization,hospitalization cost,and postoperative complications of the two groups were observed.Results The respiratory rate of the experimental group was lower than that of the control group 24h after surgery(20.21±3.10),(17.20±1.23)times/min vs(23.60±4.14)times/min,(19.12±2.30)times/min.And the oxygenation index was higher than that of the control group(313.24±14.90)mmHg/%,(352.60±17.97)mmHg/%vs(261.30±13.87)mmHg/%,(300.58±15.80)mmHg/%,with significant statistical significance(t=3.590,4.031,14.449,11.907,P<0.05).The preoperative estimated amount of pleural effusion in the experimental group was lower than that in the control group(115.40±45.65)mL,(92.67±21.30)mL vs(174.63±54.80)mL,(215.40±34.25)mL,with statistically significant difference(t=4.548,16.666,P<0.05).The visual simulation score(VAS)of the experimental group 24h after surgery was lower than the statistical value of the control group(2.13±0.50)points vs(5.20±0.98)points,with statistically significant difference(t=15.283,P<0.05).The number of days of drainage tube indwelling and hospitalization in the experimental group was shorter than that in the control group(1.41±0.20)d,(3.60±0.45)d vs(3.50±0.46)d,(4.99±0.80)d,and the hospitalization cost was higher than that in the control group(1.20±0.45)vs(1.01±0.10),with significant statistical significance(t=22.821,8.294,2.257,P<0.05).The total rate of postoperative complications in the experimental group was lower than that in the control group(3.33%vs 20.00%),with statistically significant difference(χ^2=4.043,P<0.05).Conclusion The clinical effect of rapid rehabilitation surgical intervention in patients with traumatic hemopneumothorax is superior,demonstrating the clinical application value.