胸腔镜辅助小切口手术与传统开胸手术治疗多发性肋骨骨折合并肺撕裂伤的效果比较  

Comparison of the effect of thoracoscopic-assisted small incision surgery and traditional thoracotomy in the treatment of multiple rib fractures complicated with lung laceration

作　　者：郭小川[1] 向毅[1] GUO Xiao-chuan;XIANG Yi(Department of Thoracic Surgery,the Fourth People′s Hospital of Sichuan Province,Sichuan Province,Chengdu610016,China)

机构地区：[1]四川省第四人民医院胸外科,四川成都610016

出　　处：《中国当代医药》2021年第11期93-96,共4页China Modern Medicine

摘　　要：目的比较胸腔镜辅助小切口手术和传统开胸手术治疗多发性肋骨骨折合并肺撕裂伤的效果。方法回顾性选取2007年10月~2019年5月四川省第四人民医院收治的61例多发性肋骨骨折合并肺撕裂伤患者作为研究对象,按照手术方法分为胸腔镜组(35例)与传统开胸组(26例)。胸腔镜组采用胸腔镜辅助行小切口肋骨骨折内固定和肺撕裂伤处修补术,传统开胸组采用开胸手术行肋骨骨折内固定和肺撕裂伤处修补术。比较两组患者的手术时间、术后呼吸机辅助时间、重症监护室(ICU)监护时间、胸引管放置时间、住院时间、术中出血量、术中内固定骨折数、术后第1天疼痛视觉模拟量表(VAS)评分、手术效果优良率及并发症发生情况。结果胸腔镜手术组的手术时间、术后呼吸机辅助时间、ICU监护时间、胸引管放置时间、住院时间均短于传统开胸组,差异有统计学意义(P<0.05)。胸腔镜组术中出血量少于传统开胸组,其差异有统计学意义(P<0.05)。胸腔镜组术后第1天VAS评分低于传统开胸组,差异有统计学意义(P<0.05)。胸腔镜组的手术效果优良率高于传统开胸组,差异有统计学意义(P<0.05)。两组患者的术中内固定骨折数和并发症总发生率比较,差异无统计学意义(P>0.05)。结论胸腔镜辅助小切口手术治疗多发性肋骨骨折合并肺撕裂伤较传统开胸手术,具有创伤小、术后疼痛轻、恢复快的优点,术后效果更好,值得临床推广。Objective To compare the effect of thoracoscopic-assisted minimal-incision surgery and conventional thoracotomy in the treatment of multiple rib fractures complicated with lung laceration.Methods A total of 61 patients with multiple rib fractures complicated with lung laceration admitted to the Fourth People′s Hospital of Sichuan Province from October 2007 to May 2019 were retrospectively selected as the research subjects,they were divided into the thoracoscopic group(35 cases)and the traditional thoracotomy group(26 cases)according to surgical methods.In the thoracoscopic group,internal fixation of rib fracture with small incision and repair of lung laceration were performed assisted by thoracoscopy,while in the traditional thoracotomy group,internal fixation of rib fracture and repair of lung laceration were performed with thoracotomy.The operative time,postoperative ventilator assistance time,intensive care unit(ICU)monitoring time,thoracic catheter placement time,hospital stay,intraoperative blood loss,intraoperative fracture number,visual analog scale(VAS)score of pain on the first day after surgery,excellent and good rate of surgical effect and incidence of complications in the two groups were compared.Results The operative time,postoperative ventilator assistance time,ICU monitoring time,thoracic catheter placement time and hospitalization time in the thoracoscopic surgery group were all shorter than those in the traditional thoracotomy group,the differences were statistically significant(P<0.05).The intraoperative blood loss in the thoracoscopic group was less than that in the traditional thoracotomy group,and the difference was statistically significant(P<0.05).The VAS score of the thoracoscopic group on the first day after surgery was lower than that of the traditional thoracotomy group,and the difference was statistically significant(P<0.05).The excellent and good rate of surgery in the thoracoscopic group was higher than that in the traditional thoracotomy group,and the difference was statistically

关 键 词：胸腔镜 传统开胸手术 多发性肋骨骨折 肺撕裂伤 效果比较 

分 类 号：R274.1[医药卫生—中医骨伤科学]