电视胸腔镜精准定位复位内固定术治疗胸外伤伴肋骨骨折的效果及对呼吸状态、疼痛反应的影响

Effect of video-assisted thoracoscopic precise positioning reduction and internal fixation in the treatment of thoracic trauma with rib fracture and its influences on respiratory status and pain response

目的探讨电视胸腔镜精准定位复位内固定术治疗胸外伤伴肋骨骨折的效果及对呼吸状态、疼痛反应的影响。方法选取2019年2月至2021年3月收治的100例胸外伤伴肋骨骨折患者为研究对象,根据手术方式不同将其分为对照组、观察组,各50例。对照组实施常规开胸复位内固定术,观察组实施电视胸腔镜精准定位复位内固定术。比较两组的治疗效果。结果观察组的术中出血量、胸管引流量少于对照组,骨折愈合时间、住院时间短于对照组,手术操作时间长于对照组(P<0.05)。术后1 d,观察组的呼气时气道阻力、吸气时气道阻力低于对照组,肺动态顺应性高于对照组(P<0.05)。术后12 h及术后1、3 d,观察组的简化McGill疼痛问卷(SF-MPQ)评分低于对照组(P<0.05)。观察组的术后并发症总发生率为8.00%,低于对照组的24.00%(P<0.05)。结论相较于开胸复位内固定术,电视胸腔镜精准定位复位内固定术不仅能够有效提升胸外伤伴肋骨骨折患者的治疗效果,促进呼吸状态恢复,还能有效减轻疼痛反应,降低术后并发症发生率,值得推广。

Objective To investigate the effect of video-assisted thoracoscopic precise positioning reduction and internal fixation in the treatment of thoracic trauma with rib fracture and its influences on respiratory status and pain response.Methods A total of 100 patients with thoracic trauma with rib fracture admitted from February 2019 to March 2021 were selected as the research objects.According to different surgical methods,the patients were divided into control group and observation group,with 50 cases in each group.The control group was treated with conventional thoracotomy reduction and internal fixation,and the observation group was treated with video-assisted thoracoscopic precise positioning reduction and internal fixation.The therapeutic effects of the two groups were compared.Results The intraoperative blood loss and chest tube drainage in the observation group were less than those in the control group,the fracture healing time and hospitalization time were shorter than those in the control group,and the operation time was longer than that in the control group(P<0.05).At 1 d after operation,the expiratory airway resistance and inspiratory airway resistance in the observation group were lower than those in the control group,and the lung dynamic compliance was higher than that in the control group(P<0.05).At 12 h,1 and 3 d after operation,the Short-Form McGill Pain Questionnaire(SF-MPQ)score of the observation group was lower than that of the control group(P<0.05).The total incidence of postoperative complications in the observation group was 8.00%,which was lower than 24.00%in the control group(P<0.05).Conclusion Compared with conventional thoracotomy reduction and internal fixation,video-assisted thoracoscopic precise positioning reduction and internal fixation can not only effectively improve the therapeutic effect of patients with thoracic trauma with rib fracture,promote the recovery of respiratory status,but also effectively alleviate pain response and reduce the incidence of postoperative complications.It is worth promoting.