【摘要】 目的:探讨胸腔镜辅助经胸内固定手术治疗多发性肋骨骨折合并血气胸患者临床效果。方法:选择2014年3月至2017年10月,于我院治疗的多发性肋骨骨折合并血气胸患者58例为研究对象,按照随机数表法平均分为实验组与对照组,每组各29例。对照组患者给予传统经胸内固定手术治疗,实验组患者给予胸腔镜辅助经胸内固定手术治疗。观察比较两组患者临床疗效、手术相关指标、病情恢复情况以及手术前后视觉模拟评分(VAS)情况。结果:实验组患者总有效率为96.6%,显著高于对照组的72.4%,差异有统计学意义(P<0.05)。实验组患者手术时间、引流管持续时间、术后出血量及住院时间均少于对照组,差异均具有统计学意义(均P<0.05)。实验组患者骨折对位率、切口愈合率和肺部复张正常率分别为96.6%、96.6%和100.0%,均明显高于对照组的72.4%、69.0%和79.3%(均P<0.05)。手术前两组患者VAS评分比较,差异无统计学意义(P>0.05);手术后两组患者VAS评分均有所下降,且实验组患者下降程度明显大于对照组(均P<0.05)。结论:胸腔镜辅助经胸内固定手术治疗多发性肋骨骨折合并血气胸患者可以明显提高治疗有效率、缩短手术时间、减少术后出血量并有效缓解患者疼痛情况,手术创伤小,患者预后较好,具有很好的临床效果。更多还原

【Abstract】 Objective: To investigate the clinical effect of thoracoscopic assisted intrathoracic fixation for the treatment of multiple rib fractures complicated with hemopneumothorax. Methods: 58 cases of multiple rib fractures with hemopneumothorax patients who were treated in our hospital from March 2015 to June 2017 were divided into experimental group and reference group according to the random number table method,29 cases in each group. Patients in the reference group were given conventional trans-thoracic surgery,while patients in the experimental group were treated by thoracoscopic assisted thoracic fixation. The clinical efficacy,operation-related indicators,condition recovery and visual analogue scale( VAS) before and after operation were observed and compared between the two groups. Results: The total effective rate of the experimental group was96. 55%,which was significantly higher than that of the reference group( 72. 41%),the difference was statistically significant( P < 0. 05). The operation time,drainage time,postoperative bleeding volume and hospital stay in the experimental group were all less than those in the reference group( P < 0. 05). In the experimental group,the rates of fracture alignment,incision healing and normal lung recruitment were 96. 55%,96. 55% and 100%,respectively,which were significantly higher than those of the reference group( 72. 41%,68. 97% and 79. 31%,P < 0. 05). There was no significant difference in VAS scores between the two groups before surgery( P > 0. 05). The VAS score of both groups decreased after operation,and the decline in the experimental group was significantly greater than that of the reference group( P < 0. 05). Conclusion: Thoracoscopic assisted intrathoracic fixation for the treatment of multiple rib fractures with hemopneumothorax patients has a good clinical effect,not only can significantly improve the treatment efficiency,but also can shorten the operation time,reduce the amount of postoperative bleeding and relieve pain in patients with less traumatic and better prognosis.更多还原