胸腔镜辅助镍钛记忆合金环抱器内固定治疗多发性肋骨骨折的疗效分析

Efficacy analysis of thoracoscopic assisted internal fixation with nickel-titanium memory alloy embracing fixator for multiple rib fractures

目的探讨胸腔镜辅助镍钛记忆合金环抱器内固定治疗多发性肋骨骨折的临床应用价值。方法回顾性分析2018年6月至2019年9月福建医科大学教学医院莆田市第一医院收治的58例多发性肋骨骨折的患者,根据治疗方法不同,分为镍钛记忆合金环抱器内固定术联合胸腔镜组(手术组,28例)和保守治疗组(非手术组,30例),比较两组患者治疗前疼痛视觉模拟(VAS)评分、治疗后第7天VAS、住院期间并发症(肺部感染)、住院时间、住院费用、胸腔闭式引流拔管时间。结果两组患者治疗前VAS、住院时间、胸腔闭式引流拔管时间比较,差异无统计学意义(P>0.05)。手术组治疗后第7天VAS显著低于非手术组(P<0.05),手术组住院费用显著高于非手术组(P<0.05),手术组肺部感染发生率明显低于非手术组(P<0.05)。结论多发性肋骨骨折患者实施胸腔镜辅助镍钛记忆合金环抱器内固定治疗费用较高,但可明显缓解疼痛、降低肺部感染发生率,值得临床推广。

Objective To explore the clinical application value of thoracoscopic assisted internal fixation with nickel-titanium memory alloy embracing fixator in the treatment of multiple rib fractures.Methods A total of 58 patients with multiple rib fractures admitted to Teaching Hospital of Fujian Medical University,the First Hospital of Putian City from June 2018 to September 2019 were analyzed retrospectively.According to different treatments,they were divided into the operation group(n=28,thoracoscopic assisted internal fixation with Ni-Ti memory alloy embracing fixator)and the non-operative group(n=30,conservative treatment).The visual analogue scale(VAS)before treatment and on the 7th day after treatment,complications during hospitalization(pulmonary infection)hospitalization stay,hospitalization cost,and extubation time of closed thoracic drainage were compared between the two groups.Results There was no significant difference in VAS,hospitalization stay and extubation time of closed thoracic drainage between the two groups before treatment(P>0.05).On the 7th day after treatment,VAS and the incidence of pulmonary infection in the operation group were significantly lower than those in the non-operative group(P<0.05),thehospitalization cost of the operation group was significantly higher than that of the non-operative group(P<0.05).and the incidences of pulmonary infection of the operation group were significantly lower than that of the nonoperation group(P<0.05).Conclusion Thoracoscopic assisted internal fixation with Ni-Ti memory alloy embracing fixator is expensive for patients with multiple rib fractures,but it can obviously relieve pain and reduce the incidence of pulmonary infection,which is worthy of clinical promotion.