单孔胸腔镜联合肋骨接骨板内固定术治疗多发性肋骨骨折并血气胸的效果

Effect of single-hole thoracoscopy combined with rib plate internal fixation in the treatment of multiple rib fractures and hemopneumothorax

目的研究单孔胸腔镜联合肋骨接骨板内固定术治疗多发性肋骨骨折并血气胸的效果。方法根据随机数字表法将本院60例多发性肋骨骨折并血气胸患者分为对照组(n=30,传统经胸内固定术)和观察组(n=30,单孔胸腔镜联合肋骨接骨板内固定术)。比较两组的治疗效果。结果观察组的切口长度、术中出血量、手术时间、术后胸引量、引流管拔除时间、下床活动时间、住院时间及骨折愈合时间均优于对照组(P<0.05)。术后1、7 d时,观察组的视觉模拟评分法(VAS)评分低于对照组(P<0.05)。术后3个月,观察组的用力肺活量(FVC)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)、最大通气量(MVV)均高于对照组(P<0.05)。观察组的优良率高于对照组,并发症总发生率低于对照组(P<0.05)。结论单孔胸腔镜联合肋骨接骨板内固定术治疗多发性肋骨骨折并血气胸安全有效。

Objective To study the effect of single-hole thoracoscopy combined with rib plate internal fixation in the treatment of multiple rib fractures and hemopneumothorax.Methods Sixty patients with multiple rib fractures and hemopneumothorax in our hospital were divided into control group(n=30,traditional transthoracic internal fixation)and observation group(n=30,single-hole thoracoscopy combined with rib plate internal fixation)according to the random number table method.The therapeutic effects of the two groups were compared.Results The incision length,intraoperative blood loss,operation time,postoperative chest drainage volume,drainage tube removal time,ambulation time,hospitalization time and fracture healing time of the observation group were better than those of the control group(P<0.05).At 1 and 7 d after operation,the score of Visual Analogue Scale(VAS)in the observation group was lower than that in the control group(P<0.05).At 3 months after operation,the forced vital capacity(FVC),percentage of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC),maximum ventilation volume(MVV)in the observation group were higher than those in the control group(P<0.05).The excellent and good rate of the observation group was higher than that of the control group,and the total incidence of complications was lower than that in the control group(P<0.05).Conclusion Single-hole thoracoscopy combined with rib plate internal fixation in the treatment of multiple rib fractures and hemopneumothorax is safe and effective.