多发性肋骨骨折胸腔镜辅助小切口外科手术治疗31例体会  

Experience in surgically treating 31 patients with multiple fractured ribs by video-assisted mini thoracotomy

作　　者：刘孙伟 李新武 唐宇 王春海 刘其贵 

机构地区：[1]湖南省武冈市人民医院胸外科,湖南武冈422400

出　　处：《中国现代医生》2013年第21期127-129,共3页China Modern Doctor

摘　　要：目的探讨多发性肋骨骨折外科手术治疗的经验和方法。方法采用华森医疗纯钛肋骨接骨板和胸腔镜辅助小切口外科手术治疗31例多发性肋骨骨折患者。回顾性分析、观察其临床疗效和并发症。结果共使用肋骨接骨板158个,平均(5.10±3.45)个;手术时间45～180 min,平均(80.16±32.98)min;术后平均(3.0±0.89)d能坐起,使用呼吸训练器达到1200 mL/s,吸气流速时的平均时间为(5.03±1.35)d,术后胸管留置时间(4.39±1.59)d。全组无气管切开,31例临床痊愈。所有病例无遗留胸廓畸形,随访3～32个月患者恢复良好。结论采用华森医疗纯钛肋骨接骨板和胸腔镜辅助小切口外科手术治疗多发性肋骨骨折术式较简单、创伤小、安全;术后活动早、恢复快、并发症少、内固定满意,值得进一步推广使用。Objective To explore the clinical experience and methods of surgical procedures on multiple fractured ribs. Methods Video-assisted mini-thoracotomy combined with Watson medical titanium rib bone plate was used to treat 31 patients with multiple rib fractures. The clinical data were analyzed retrospectively, the clinical efficacy and the incidence rate of postoperative complication were examined. Results The total number of titanium rib bone plate used was 158 with the mean number （5.10 ＋_3.45）. The average operation time was 45 to 180 min （80.16＋_32.98）. The average time to first activity out of bed was （3.0--ff）.89） d. The postoperative time to reach 1200 ml/s with the breath train- ing machine was （5.03＋-1.35） d. The average chest drainage duration was （4.39＋1.59） d. There was no tracheotomy in the group and the chest incision was healed well. All eases were followed up 3 to 32 months and 31 eases were clini- cally cured without any thoracic deformity. Conclusion Using Watson medical titanium rib bone plate combined with video-assisted thoracic small incision to treat multiple rib fractures is technically safe and feasible and minimally in- vasive. Because of its early postoperative ambulation, rapid recovery, less complications and satisfied internal fixation, it deserves our application in the treatment of multiple fractured ribs.

关 键 词：肋骨接骨板 胸腔镜辅助外科手术 内固定 多发性肋骨骨折 

分 类 号：R687.3[医药卫生—骨科学]