微创完全胸腔镜肋骨骨折胸腔内固定术对比传统肋骨骨折内固定术对患者疼痛、异物感等术中术后相关指标的影响

Effect of minimally invasive complete thoracoscopic intrathoracic fixation of rib fracture in the thoracic cavity comparing with traditional intrathoracic fixation of rib fracture on intraoperative and postoperative related indexes such as pain and foreign body sensation in patients

目的 探讨微创完全胸腔镜肋骨骨折胸腔内固定术对比传统肋骨骨折内固定术对患者疼痛、异物感等术中术后相关指标的影响。方法 选取2022年1月至2024年1月广东省珠海市第五人民医院胸外科收治的需行手术治疗的肋骨骨折患者120例。依据手术方式将上述患者分为试验组和对照组,每组60例。试验组采用微创完全胸腔镜肋骨骨折胸腔内固定术,对照组采用传统肋骨骨折内固定术。观察两组术后12、24、48、72 h视觉模拟评分法(VAS)评分,术后1周、2周、1个月、3个月异物感评分,手术时间,术中出血量,术后引流量,术后拔除引流管时间,术后二次行胸腔穿刺术情况。结果 两组术后VAS评分组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组术后各时间点VAS评分比较,差异有统计学意义(P<0.05);组间比较:试验组术后各时间点VAS评分均低于对照组(P<0.05)。整体分析发现:两组术后异物感评分组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。组内比较:两组术后各时间点异物感评分比较,差异有统计学意义(P<0.05);组间比较:试验组术后各时间点异物感评分均低于对照组(P<0.05)。试验组手术时间、术中出血量、术后引流量、拔管时间、术后二次穿刺例数均少于对照组(P<0.05)。结论 微创完全胸腔镜肋骨骨折胸腔内固定术对比传统肋骨骨折内固定术优势显著,但仍需结合患者情况做到个体化选择。

Objective To explore the effect of minimally invasive complete thoracoscopic intrathoracic fixation of rib fracture in the thoracic cavity comparing with tradition intrathoracic fixation of rib fracture on intraoperative and postoperative related indexes such as pain and foreign body sensation in patients.Methods One hundred and twenty patients with rib fractures requiring surgical treatment admitted to the Department of Thoracic Surgery,the Fifth People’s Hospital of Zhuhai,Guangdong Province from January 2022 to January 2024 were selected.Based on the surgical method,the above patients were divided into the experimental group and the control group,with 60 cases in each group.Minimally invasive complete thoracoscopic intrathoracic fixation of rib fractures in the thoracic cavity was used in the experimental group and traditional intrathoracic fixation of rib fracture was used in the control group.The visual analogue scale(VAS)score at 12,24,48,and 72 h postoperatively,foreign body sensation scores at one week,two weeks,one month,and three months postoperatively,operation time,intraoperative bleeding volume,postoperative drainage volume,postoperative time of drain removal,and postoperative secondary thoracentesis were observed in the two groups.Results Overall analysis found that:the differences in postoperative VAS scores between groups,time point comparisons,and inter-actions of the two groups were statistically significant(P<0.05).Intra-group comparison:there was statistical significance in VAS scores between the two groups at various postoperative time points(P<0.05).Comparison between groups:VAS scores of experimental group were lower than control group at various postoperative time points(P<0.05).Overall analysis found that:the differences in postoperative foreign body sensation scores between groups,time point comparisons,and interactions of the two groups were statistically significant(P<0.05).Intra-group comparison:there were statistically significant differences in foreign body sensation scores between the two groups at various postoperative time points(P<0.05).Comparison between groups:the foreign body sensation scores of the experimental group were lower than those of the control group at various postoperative time points(P<0.05).The operative time,intraoperative bleeding volume,postoperative drainage volume,extubation time,and the number of postoperative secondary puncture cases in experimental group were all lower than those in control group(P<0.05).Conclusion Minimally invasive complete thoracoscopic intrathoracic fixation of rib fractures in the thoracic cavity has significant advantages over conventional intrathoracic fixation of rib fractures,but still needs to be individualised to the patient.