胸腔镜辅助下小切口钛合金或镍钛记忆合金纯钛肋骨接骨板固定术治疗多发性肋骨骨折的疗效  

Study on the Effect of Thoracoscopic-assisted Mini-incision(Titanium alloy or Nickel-titanium memory alloy pure titanium) Rib Plate Fixation in the Treatment of Multiple Rib Fractures

作　　者：叶志彬[1] 李伟阳[1] 周建平[1] 杜巍[1] 曹卫东 陈小聪[1] 黎昱江[1] YE Zhibin;LI Weiyang;ZHOU Jianping;DU Wei;CAO Weidong;CHEN Xiaocong;LI Yujiang(Department of Thoracic Surgery,Dongguan People's Hospital,Dongguan 523000,China)

机构地区：[1]东莞市人民医院心胸外科,广东东莞523059

出　　处：《中国医药指南》2020年第22期7-9,共3页Guide of China Medicine

摘　　要：目的探讨胸腔镜辅助下小切口钛合金或镍钛记忆合金纯钛肋骨接骨板固定术治疗多发性肋骨骨折的疗效。方法将2014年1月至2018年1月在我院心胸外科治疗的53例多发性肋骨骨折患者随机分为两组,对照组20例采用常规保守治疗,观察组33例采用胸腔镜辅助下小切口钛合金或镍钛记忆合金纯钛肋骨接骨板固定术治疗,比较两组患者的骨折愈合情况、并发症发生率、各项治疗指标、肺功能及血气分析指标变化。结果观察组患者治疗优良率为93.94%,明显高于对照组患者的65.00%(P<0.05);观察组患者肺部感染、肺不张、胸廓畸形、包裹性胸腔积液等并发症发生率明显低于对照组(P<0.05);观察组患者机械通气时间、胸腔引流管放置时间、自主下床活动时间、ICU监护时间、住院时间明显短于对照组,VAS评分、镇痛药物使用剂量明显少于对照组(P<0.05);观察组患者治疗后FVC、MVV、FEV1、PaO2明显高于对照组,而PaCO2明显低于对照组(P<0.05)。结论胸腔镜辅助下小切口钛合金或镍钛记忆合金纯钛肋骨接骨板固定术治疗多发性肋骨骨折的疗效显著,能有效提升骨折愈合效果,加快恢复速度,降低疼痛程度,促进肺功能及血氧含量的升高,具有积极的临床意义。Objective To investigate the effect of thoracoscopically assisted small-incision titanium alloy or nickel-titanium memory alloy pure titanium rib plate fixation in the treatment of multiple rib fractures.Methods Will be in January 2014 to January 2018 in our hospital patients with thoracic surgical treatment of 53 cases of multiple fractured ribs were randomly divided into two groups,control group 20 cases with conventional conservative treatment,observation group of 33 cases of thoracoscope assisted small incision or nickel titanium memory alloy pure titanium alloys and rib bone plate fixation treatment,compared two groups of patients with fracture healing,complications,treatment index,pulmonary function and blood gas analysis index changes.Results The excellent and good rate of treatment in the observation group was 93.94%,which was significantly higher than 65.00%in the control group(P<0.05).The incidence of pulmonary infection,atelectasis,thoracic deformity,encapsulated pleural effusion and other complications in the observation group was significantly lower than that in the control group(P<0.05).The time of mechanical ventilation,thoracic drainage tube placement,time of spontaneous movement out of bed,ICU monitoring and hospitalization in the observation group were significantly shorter than those in the control group,and the VAS pain score and the dose of analgesic drugs were significantly less than those in the control group(P<0.05).After treatment,FVC,MVV,FEV1 and PaO2 in the observation group were significantly higher than those in the control group,while PaCO2 was significantly lower than that in the control group(P<0.05).Conclusion Thoracoscopically assisted small-incision titanium alloy or nickel-titanium memory alloy pure titanium rib plate fixation for the treatment of multiple rib fractures has a significant effect,which can effectively improve the effect of fracture healing,speed up the recovery,reduce the degree of pain,promote lung function and the increase of blood oxygen content,and has positi

关 键 词：多发性肋骨骨折 小切口钛合金或镍钛记忆合金纯钛肋骨接骨板固定术 胸腔镜 临床疗效 

分 类 号：R683.1[医药卫生—骨科学] R616.2[医药卫生—外科学]