微创胸腔镜手术治疗多发肋骨骨折的临床疗效分析  

Analysis of Clinical Efficacy of Video-assisted Thoracoscopic Treatment of Multiple Rib Bone Plate

作　　者：李建国[1,2] 张逊[3] 刘立志[2] 李树满[2] LI Jianguo ZHANG Xun LIU Lizhi et al(Graduate School of Medical University of Tianjin 30007)

机构地区：[1]天津医科大学研究生院,天津市300070 [2]天津市北辰医院外科 [3]天津市胸科医院胸外科

出　　处：《医学理论与实践》2017年第4期482-483,486,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨胸腔镜辅助肋骨接骨板(Rib bone plate,RBP)治疗外伤性多发肋骨骨折(Trauma rib fracture,TRF)的临床疗效。方法:选取天津市北辰医院收治的TRF患者68例,其中胸腔镜辅助RBP手术组31例,非手术组37例,非手术组即行多头胸带及胸部护板外固定治疗。分析两组治疗后床上坐起时间、下床活动时间、住院时间、痊愈时间;两组治疗后第1、4、7、10天的视觉模拟评分(VAS);两组使用止痛剂频次。结果:腔镜组治疗后床上坐起时间、下床活动时间、住院时间、痊愈时间均显著短于非手术组(P<0.05);1周后胸腔镜组VAS分值显著小于非手术组(P<0.05);治疗后1周后,腔镜组的PaO_2显著高于非手术组(P<0.05);而并发症(12.9%)明显小于非手术组(54.1%)(P<0.05)。结论:采用胸腔镜RBP法治疗胸部创伤肋骨骨折,可有效缩短卧床时间、减少止痛药物用量及并发症发生率,促进患者愈合,极大地提高了患者生活质量,及早回到工作岗位,适合临床广泛应用。Objective： To study the analysis of tboracoseopic rib bone plate clinical efficacy in the treatment for TRF. Methods： By using the method of retrospective analysis from June 2011 to June 2015 in our hospital were traumatic rib fractures in 68 cases, group 31 cases of tboracoscopic surgery group rib plate among them,37 cases of non operation, non operation group was long chest with a chest protection plate and external fixation. Analysis of the two groups after treatment bed time, ambulation time, hospitalization time, healing time; the 1st, 4th, 7th, 10th days of VAS after treatment in two groups; the two group of analgesics use frequency; detection level of PaO2 for 1 week before and after treatment：1 month complications two of group. Results： the treatment group after endoscopic bed time, ambulation time, were statistical lower than control patients （P〈0. 05）;the two groups were treated for 1 week the visual analogue scale （VAS）, laparoscopic group was statistical lowe （P〈0. 05）;1 week post-treatment, PaO2 is significant higher（P〈0. 05） ;the complications were 12. 9% and 54. 1% respectively with statistical difference（P〈0. 05）. Conclusion：The combined thoracoscopic rib plate can reduce analgesics, the incidence of complications, shorten the patient discomfort after the injury time, greatly improve the quality of life of the patients, early return to work, suitable for wide clinical application.

关 键 词：肋骨骨折 微创腔镜手术 临床疗效 并发症 

分 类 号：R683.1[医药卫生—骨科学]