单孔胸腔镜辅助爪形接骨板内固定手术治疗多发性肋骨骨折合并血气胸临床分析

Clinical Analysis of Single-hole Thoracoscopic-assisted Claw Plate Internal Fixation for Multiple Rib Fractures with Hemopneumothorax

目的研讨多发性肋骨骨折合并血气胸患者接受单孔胸腔镜辅助爪形接骨板内固定手术治疗的临床价值。方法方便选取该院于2012年1月—2018年8月收治的82例多发性肋骨骨折合并血气胸患者作为观察对象,并按照手术方法分两组,对照组(n=40)接受传统爪形接骨板内固定手术处理,观察组(n=42)在单孔胸腔镜辅助下行爪形接骨板内固定手术治疗,对比两组的胸壁切口长度、手术时间、术中出血量、术后胸引量以及术后住院时间等指标。结果观察组的手术总有效率(97.6%)显著高于对照组(80.0%),差异有统计学意义(χ2=4.830,P<0.05)。与对照组比较,观察组的手术时间(64.8±13.2)min、术中出血量(58.3±8.9)mL、术后胸引量(354.5±24.8)mL、术后住院时间(13.8±2.2)d均显著优于对照组的(81.3±15.5)min、(103.6±17.2)mL、(448.9±30.7)mL,(16.5±1.3)d,差异有统计学意义(t=5.198、15.082、15.351、6.723,P<0.05)。观察组的切口愈合率、骨折对位率、肺部正常复张率分别为97.6%、97.6%,100.0%,较对照组的80.0%、77.5%、80.0%均显著提高(χ2=4.830、5.979、7.175,P<0.05)。结论在单孔胸腔镜辅助下对多发性肋骨骨折合并血气胸患者行爪形接骨板内固定手术处理,整体效果较为理想。

Objective To study the clinical value of single-hole thoracoscopy-assisted claw plate internal fixation for multiple rib fractures with hemopneumothorax.Methods 82 patients with multiple rib fracture complicated with hemopneumothorax from January 2012 to August 2018 in the hospital were convenient selected as the observation objects.According to the operation method,two groups were divided into two groups.The control group(n=40)received traditional claw plate internal fixation.The observation group(n=42)underwent claw plate internal fixation assisted by single-hole thoracoscope.The length of thoracic incision,operation time,intraoperative blood loss,postoperative thoracic drainage and hospitalization time were compared between the two groups.Results The total effective rate of the observation group(97.6%)was significantly higher than that of the control group(80.0%),with statistical significance(χ2=4.830,P<0.05).Compared with the control group,the operation time(64.8±13.2)min,intraoperative blood loss(58.3±8.9)mL,postoperative chest volume(354.5±24.8)mL,and postoperative hospitalized time(13.8±2.2)d in the observation group were significantly better than those in the control group.In the group(81.3±15.5)min,(103.6±17.2)mL,(448.9±30.7)mL,and(16.5±1.3)d,with statistically significant(t=5.198,15.082,15.351,6.723,P<0.05).The incision healing rate,fracture alignment rate,and normal lung expansion rate in the observation group were 97.6%,97.6%,and 100.0%,which were significantly higher than the control group's 80.0%,77.5%,and 80.0%(χ2=4.830,5.979,7.175,P<0.05).Conclusion Claw plate internal fixation for multiple rib fractures with hemopneumothorax assisted by single-hole thoracoscopy is effective.