单孔胸腔镜联合内固定术治疗多发性肋骨骨折并血气胸的临床有效性分析

Analysis of the Clinical Effectiveness of Single-port Thoracoscopy Combined with Internal Fixation in the Treatment of Multiple Rib Fractures Complicated with Blood Pneumothorax

目的分析单孔胸腔镜联合内固定术治疗多发性肋骨骨折合并血气胸的临床疗效。方法随机抽取82例该院2016年7月—2018年9月间收治的多发性肋骨骨折并血气胸患者,平均分为对照组与观察组,每组41例,对照组采用传统经胸内固定术治疗,观察组则在此基础上联用单孔胸腔镜辅助治疗,比较两组患者的临床治疗效果。结果治疗后观察组患者的胸痛缓解时间、自行下床活动时间、胸腔引流管拔出时间及住院时间(6.4±1.7)、(6.1±1.7)、(2.9±0.5)、(13.0±2.3)d均短于对照组的(11.2±2.2)、(19.1±2.0)、(6.9±1.5)、(20.1±3.2)d,差异有统计学意义(P<0.05);观察组术后出血量(55.6±10.1)mL、手术用时(65.1±18.2)min以及术后胸引量(355.8±25.2)mL均少于对照组的(105.4±15.3)mL、(85.3±9.8)min、(450.1±30.3)mL,差异有统计学意义(P<0.05);观察组的治疗总有效率92.7%高于对照组的75.6%,差异有统计学意义(χ^(2)=4.479,P<0.05);观察组患者的并发症发生率12.2%低于对照组的31.7%,差异有统计学意义(χ^(2)=4.556,P<0.05)。结论单孔胸腔镜联合传统胸内固定治疗的临床疗效优于仅单一进行传统经胸内固定治疗,无较大手术创伤,出血量少,且能有效缓解患者疼痛,安全性高。

Objective To analyze the clinical efficacy of single-port thoracoscopy combined with internal fixation in the treatment of multiple rib fractures with hemopneumothorax.Methods A random sample of 82 patients with multiple rib fractures and blood pneumothorax admitted to the hospital between July 2016 and September 2018 were divided into the control group and the observation group,with 41 cases in each group.The control group was treated with traditional transthoracic fixation;on this basis,the observation group was combined with single-port thoracoscope adjuvant treatment to compare the clinical treatment effects of the two groups of patients.Results After treatment,the observation group patients'chest pain relief time,self-outing time,chest drainage tube withdrawal time,and hospitalization time were(6.4±1.7)d,(6.1±1.7)d,(2.9±0.5)d,(13.0±2.3)d was shorter than the control group's(11.2±2.2)d,(19.1±2.0)d,(6.9±1.5)d,(20.1±3.2)d,the difference was statistically significant(P<0.05);postoperative bleeding in the observation group(55.6±10.1)mL,operation time(65.1±18.2)min and postoperative chest drainage(355.8±25.2)mL were all less than the control group(105.4±15.3)mL,(85.3±9.8)min,(450.1±30.3)mL,the difference was statistically significant(P<0.05);the total effective rate of 92.7%of the observation group was higher than 75.6%of the control group,the difference was statistically significant(χ^(2)=4.479,P<0.05);and the complication rate of the observation group was 12.2%lower than that of the control group 31.7%,the difference was statistically significant(χ^(2)=4.556,P<0.05).Conclusion The clinical efficacy of single-port thoracoscopy combined with traditional chest fixation is better than traditional transthoracic fixation alone.There is no major surgical trauma,less bleeding,and it can effectively relieve the pain of patients with high safety.