胸部创伤给予胸腔镜手术治疗的效果分析  

Analysis of Effect of Thoracoscopy in Treatment of Thoracic Trauma

作　　者：孙超[1] 邱福敏 陶西彪 袁东朋[1] SUN Chao;QIU Fumin;TAO Xibiao;YUAN Dongpeng(Department of Chest Surgery,Donghai People’s Hospital,Lianyungang,Jiangsu Province,222300 China)

机构地区：[1]东海县人民医院胸心外科,江苏连云港222300

出　　处：《系统医学》2017年第23期63-64,134,共3页Systems Medicine

摘　　要：目的探讨胸部创伤给予胸腔镜手术治疗的临床效果。方法选取该院于2013年3月—2017年3月收治的66例有稳定血流动力学的胸部创伤患者,按数字表随机分为两组,各组33例,对照组行常规开胸手术治疗,观察组行胸腔镜手术治疗,观察与对比两组术中出血量、手术时间、术后恢复情况、术后视觉模拟评分(VAS)及术后各炎症因子水平。结果观察组术中出血量[(172.94±134.5)m L]、手术时间[(45.61±24.73)min]较对照组(351.41±78.8)m L、(95.54±33.24)min],均少于后者(t=19.584、13.855,P<0.05);住院时间(6.11±2.52)d、下床活动时间(1.66±0.27)d、恢复日常生活时间(9.53±1.23)d均短于对照组(8.15±1.34)d、(3.28±1.68)d、(17.44±5.42)d](t=8.653、9.540、21.553,P<0.05);术后24 h引流液量(280.61±57.53)m L]少于对照组[(254.34±54.33)m L(t=15.353,P<0.05)。两组术后并发症情况比较,差异无统计学意义(P>0.05)。两组术后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)相比手术前,均偏高,组间比较差异有统计学意义(P<0.05)。结论胸部创伤者行胸腔镜手术治疗,能减轻其手术痛苦,减少手术感染,加速康复进程,实为一种安全、有效的手术方式。Objective To study the clinical effect of thoracoscopy in treatment of thoracic trauma.Methods 66 cases of thoracic trauma patients with steady hemodynamics admitted and treated in our hospital from March 2013 to March 2017 were selected and randomly divided into two groups with 33 cases in each group,the control group used the routine thoracotomy for treatment,while the observation group used the thoracoscopy for treatment,and the intraoperative bleeding amount,operation time,postoperative recovery and VAS and various inflammatory factors levels after surgery of the two groups were observed and compared.Results The intraoperative bleeding amount and operation time in the observation group were lower than those in the control group(172.94±134.5)mL,(45.61±24.73)min vs(351.41±78.8)mL,(95.54±33.24)min](t=19.584,13.855,P<0.05),and the length of stay,time to get out of bed and daily life recovery time were shorter than those in the control group(6.11±2.52)d,(1.66±0.27)d,(9.53±1.23)d vs(8.15±1.34)d,(3.28±1.68)d,(17.44±5.42)d(t=8.653,9.540,21.553,P<0.05),and the drainage amount in 24h after surgery was lower than that in the control group(280.61±57.53)mL vs(254.34±54.33)mL,(t=15.353,P<0.05),and the difference in the complications after surgery between the two groups was not obvious(P>0.05),and the IL-6,TNF-αand CRP of the two groups were higher than those before operation,and the differences were statistically significant(P<0.05).Conclusion The thoracoscopy in treatment of thoracic trauma patients can relieve the operation pains,reduce the operation infection,accelerate the recovery process,and it is a safe and effective operation method.

关 键 词：胸部创伤 胸腔镜 感染 

分 类 号：R655[医药卫生—外科学]