急诊胸腔镜手术治疗重症胸部创伤合并创伤性休克的临床疗效评估

Evaluation of the Clinical Effect of Thoracoscopic Surgery in the Treatment of Severe Chest Trauma Complicated with Traumatic Shock

目的观察重症胸部创伤合并创伤性休克患者采用急诊胸腔镜手术治疗对其肺功能指标的影响。方法选取2018年1月—2022年12月期间北京市昌平区医院收治的60例重症胸部创伤合并创伤性休克患者为研究对象,采用抽签法分为对照组、研究组,各30例。对照组采用常规开胸手术治疗、研究组采用急诊胸腔镜手术治疗。对比两组患者临床指标、肺功能指标以及不良事件发生率。结果研究组经治疗输液量(1720.11±21.32)mL、C反应蛋白(108.44±3.66)mg/L、红细胞压积(32.01±1.45)%、凝血酶原时间(11.42±0.23)s优于对照组(2901.14±21.45)mL、(129.47±3.58)mg/L、(23.67±0.34)%、(17.77±0.21)s,差异有统计学意义(t=213.892、22.498、30.671、111.673,P<0.05)。治疗前,两组患者动脉血氧分压(partial arterial oxygen pressure,PaO_(2))、动脉血二氧化碳分压(arterial carbon dioxide partial pressure,PaCO_(2))比较,差异无统计学意义(P>0.05);治疗后,研究组PaO_(2)、PaCO_(2)优于对照组,差异有统计学意义(P<0.05)。研究组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论对重症胸部创伤合并创伤性休克患者采用急诊胸腔镜手术治疗,可改善患者临床指标以及肺功能指标,降低不良事件发生率。

Objective To observe the effect of thoracoscopic surgery on pulmonary function in patients with severe thoracic trauma complicated with traumatic shock.Methods 60 patients with severe chest trauma combined with traumatic shock treated in Changping District Hospital of Beijing from January 2018 to December 2022 were selected as the study subjects,and were divided into control group and study group by drawing lots,with 30 cases in each group.The control group was treated with conventional thoracotomy,while the study group was treated with emergency thoracoscopic surgery.Clinical indicators,pulmonary function indicators and the incidence of adverse events were compared between the two groups.Results The infusion volume(1720.11±21.32)mL,C-reactive protein(108.44±3.66)mg/L,hematopoietic volume(32.01±1.45)%and prothrombin time(11.42±0.23)s of the study group were better than those of the control group(2901.14±21.45)mL and(129.47±3.58)mg/L,(23.67±0.34)%,(17.77±0.21)s,the difference was statistically significant(t=213.892,22.498,30.671,111.673,P<0.05).Before treatment,arterial carbon dioxide partial pressure(PaO_(2))and arterial carbon dioxide partial pressure(PaCO_(2))were compared between the two groups,the difference was no statistically significant(P>0.05).After treatment,PaO_(2) and PaCO_(2) in the study group were better than those in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse events in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Thoracoscopic surgery in patients with severe chest trauma combined with traumatic shock can improve clinical indexes and lung function indexes of patients and reduce the incidence of adverse events.