经胸腔镜内固定手术治疗多发性肋骨骨折的临床疗效及肺通气障碍改善作用分析  

Clinical Effect of Thoracoscopic Internal Fixation in Treatment Multiple Rib Fractures and Analysis of Analysis the Ameliorative Effect of Pulmonary Ventilation Disorde

作　　者：罗化 彭建明 袁跃西 LUO Hua;PENG Jianming;YUAN Yuexi(Changsha Central Hospital Affiliated to Nanhua University, Hunan Changsha 413000, China)

机构地区：[1]南华大学附属长沙中心医院,湖南长沙413000

出　　处：《河北医学》2020年第4期664-668,共5页Hebei Medicine

基　　金：湖南省科技计划项目,(编号:2009SK31002)。

摘　　要：目的:分析经胸腔镜内固定手术治疗多发性肋骨骨折的临床疗效及肺通气障碍改善作用。方法:选择2017年10月至2019年1月在我院接受治疗的112例多发性肋骨骨折患者,按照简单随机法分为对照组(n=54)和治疗组(n=58),对照组采用传统切开复位内固定手术,治疗组采用胸腔镜内固定手术。比较两组手术情况,临床疗效,手术前后视觉模拟评分(VAS)、血气分析、肺通气功能变化情况,和并发症发生情况。结果:治疗组切口长度、手术时间、术中出血量、术后胸腔引流量、术后呼吸机使用时间和住院时间均少于对照组(P<0.05)。术后1d、3d,两组VAS、动脉血二氧化碳分压(PaCO2)均下降,治疗组低于对照组,动脉血氧分压(PaO2)均上升,治疗组高于对照组;术后14d、6个月,两组第1秒用力呼气容积(FEV1)、最大通气量(MVV)、用力肺活量(FVC)均上升,治疗组高于对照组,两组VAS、血气分析和肺通气功能指标在时间和组别之间有交互作用,即两组组间在术后1d、3d以上各指标均有统计学差异(P<0.05),两组组内术后1d、3d以上各指标均有统计学差异(P<0.05)。治疗组并发症发生率低于对照组(P<0.05)。结论:经胸腔镜内固定手术治疗多发性肋骨骨折安全有效,能够有效减轻肺通气功能障碍,且术后并发症少。Objective:To analyze the thoracoscopic internal fixation in treatment multiple rib fractures and analysis of analysis the ameliorative effect of pulmonary ventilation disorder.Methods:112 patients with multiple rib fractures who were treated in our hospital from October 2017 to January 2019,theoe patients were divided into control group(n=54)and treatment group(n=58)according to simple random method.The control group was treated with traditional open reduction and internal fixation,while the treatment group was treated with thoracoscopic internal fixation.The operation conditions,clinical efficacy,visual analogue scale(VAS),blood gas analysis,changes in pulmonary ventilation function before and after the operation and complications between the two groups were compared.Results:The incision length,operation time,intraoperative blood loss,postoperative thoracic drainage volume,postoperative ventilator usage time and hospitalization time of the treatment group were lesser than those in the control group(P<0.05).On the 1st and 3rd day after operation,VAS and arterial blood carbon dioxide partial pressure(PaCO2)in both groups decreased.The treatment group was lower than the control group,while arterial oxygen partial pressure(PaO2)in both groups increased.The treatment group was higher than the control group.14 days and 6 months after operation,the forced expiratory volume(FEV1),maximum ventilation volume(MVV)and forced vital capacity(FVC)in the first second of the two groups all increased.the treatment group was higher than the control group.VAS,blood gas analysis and pulmonary ventilation function indexes of the two groups had interaction between time and groups.there were statistically significant differences between the two groups in the above indicators 1d and 3d postoperatively(P<0.05),there were statistically significant differences within two groups in the above indicators 1d and 3d postoperatively(P<0.05).The incidence of complications in the treatment group was lower than that in the control group(P<0.05).Con

关 键 词：多发性肋骨骨折 胸腔镜内固定 临床疗效 肺通气功能 

分 类 号：R687.3[医药卫生—骨科学]