快速康复理念在创伤性肋骨骨折手术中的应用  

The application of enhanced recovery idea in surgery for traumatic rib fractures

作　　者：王刚[1] 景宝利 宋哲[1] 戚斌 冯尚华 贺静[1] 周劲松[1] Wang Gang;Jing Baoli;Song Zhe;Qi Bin;Feng Shanghua;He Jing;Zhou Jinsong(Department of Thoracic Surgery,Honghui Hospital Affiliated to School of Medicine,Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安交通大学医学院附属红会医院胸部外科,710054

出　　处：《中华胸部外科电子杂志》2019年第1期17-20,共4页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

摘　　要：目的探讨快速康复理念在创伤性肋骨骨折手术中的应用。方法搜集2017年8月至2018年1月西安市红会医院胸外科收治的64例创伤性肋骨骨折患者的临床资料。按治疗方式的不同分为快速康复组(n=36)和常规治疗组(n=28)。比较两组患者的手术切口长度、手术时间、术中出血量、术后第1天视觉模拟评分(VAS评分)、拔除胸腔闭式引流管时间、术后第3天最大自由通气量(MVV)、胃肠道功能恢复时间、平均住院时间及住院费用。结果快速康复组手术切口长度短于常规治疗组,术中出血量少于常规治疗组,差异均有统计学意义(P<0.05);但两组间手术时间比较,差异无统计学意义(P>0.05)。快速康复组术后第1天VAS评分低于常规治疗组,拔除胸腔闭式引流管时间短于常规治疗组,术后第3天MVV值大于常规治疗组,胃肠道恢复时间短于常规治疗组,平均住院时间短于常规治疗组,差异均有统计学意义(P<0.05);但两组间住院费用比较差异无统计学意义(P>0.05)。结论快速康复理念应用于创伤性肋骨骨折手术中具有明显优势,应在临床中广泛推广。Objective To explore the application of enhanced recovery idea in surgery for traumatic rib fractures.Methods 64 patients with traumatic rib fractures admitted to the Department of Thoracic Surgery,Honghui Hospital Affiliated to School of Medicine,Xi'an Jiaotong University from August 2017 to January 2018 were randomly selected.Patients were divided into two groups according to different surgical management,28 cases of conventional treatment group and 36 cases of enhanced recovery group.The clinical data were analyzed and compared between the two groups,including incision length,operation time,intraoperative blood loss,postoperative visual analogue scale(VAS)score on first postoperative day,time to pull out chest closed drainage tube,maximal voluntary ventilation(MVV)on 3rd postoperative day,recovery time of gastrointestinal function,average length of hospital stay,and cost of hospitalization.Results The incision length and intraoperative blood lose of the enhanced recovery group improved significantly compared with the conventional treatment group(P<0.05),while the two groups had no significant differences in operation time(P>0.05).Compared with the conventional treatment group,the enhanced recovery group had lower postoperative VAS score on first postoperative day;reduced time to pull out chest closed drainage tube;had greater MVV on 3rd postoperative day;reduced the recovery time of gastrointestinal function;and as a result,also reduce the average length of hospital stay(P<0.05).However,there were no significant differences in cost of hospitalization(P>0.05).Conclusions The enhanced recovery idea has absolute advantages in operation for traumatic rib fractures,and should be widely applied in clinical treatment.

关 键 词：肋骨骨折 创伤 快速康复理念 手术 

分 类 号：R687.3[医药卫生—骨科学]