胸腔镜辅助下MIPO治疗创伤性多发肋骨骨折的临床疗效  

Clinical efficacy of video-assisted thoracoscopic assisted minimally invasive plate oseoynthesis in the treatment of traumatic multiple rib fractures

作　　者：李震宇[1] 张朋朋[1] 常亮[1] 韩全胜[1] 庞文勇 闵玉丛 张磊冰[1] LI Zhen-yu;ZHANG Peng-peng;CHANG Liang;HAN Quan-sheng;PANG Wen-yong;MIN Yu-cong;ZHANG Lei-bing(Department of Emergency Surgery,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院急诊外科,贵州贵阳550002

出　　处：《川北医学院学报》2023年第9期1173-1177,共5页Journal of North Sichuan Medical College

基　　金：贵州省科技厅黔科合支撑项目(【2020】4Y164号)。

摘　　要：目的:探究电视胸腔镜(VATS)辅助微创钢板内固定术(MIPO技术)治疗创伤性多发肋骨骨折的临床疗效。方法:回顾性收集124例多发肋骨骨折患者的临床资料并按手术方式分组,其中MIPO组64例,切开复位组60例。比较两组患者基线指标、影像学指标、手术相关指标、疼痛评分(VAS)、临床疗效和并发症发生率。结果:与切开复位组相比,MIPO组患者年龄、性别、致伤原因,骨折部位、肋骨骨折根数、胸部简明创伤评分(AIS)差异无统计学意义(P>0.05)。MIPO组患者术中出血量(180.0,230.0)mL低于切开复位组[(210.0,300.0)mL,P<0.05];MIPO组手术切口长度(7.0,12.0)cm短于切开复位组[(14.5,27.0)cm,P<0.05];MIPO组手术时间(145.0±57.7)min短于切开复位组[(171.4±64.6)min,P<0.05];MIPO组引流管放置时间(5.0,7.0)d,短于切开复位组[(7.0,9.0)d,P<0.05];MIPO组住院时间短于切开复位组[(20.1±8.5 vs.23.9±11.0)d,P<0.05]。与切开复位组相比,MIPO组患者术后并发症发生率显著降低(P<0.05)。结论:VATS辅助MIPO内固定术治疗创伤性RF能够显著提高临床疗效,相对创伤小、疼痛轻、术后恢复快。Objective:To evaluate the clinical efficacy of video-assisted thoracoscopic(VATS)assisted minimally invasive plate oseoynthesis(MIPO)in the treatment of traumatic multiple rib fractures.Methods:124 patients with traumatic multiple rib fractures were included and divided into MIPO group(n=64)and open reduction group(n=64)according to the surgical methods.The baseline indicators,imaging indicators,surgery-related indicators,pain score(VAS),clinical efficacy,and incidence of complications were compared between both groups of patients.Results:Compared with the open reduction group,there was no statistically significant difference in age,gender,cause of injury,fracture site,number of rib fractures,and chest concise trauma score(AIS)among patients in the MIPO group(P>0.05).The intraoperative bleeding volume in the MIPO group(180.0,230.0)mL was lower than that in the open reduction group[(210.0,300.0)mL,P<0.05],the surgical incision length in the MIPO group(7.0,12.0)cm was shorter than that in the in the open reduction group[(14.5,27.0)cm,P<0.05].The surgical time in the MIPO group was(145.0±57.7)min,which was shorter than that in the open reduction group[(171.4±64.6)min,P<0.05],the drainage tube placement time in the MIPO group was(5.0,7.0)d,which was shorter than that in the open reduction group[(7.0,9.0)d,P<0.05],the hospitalization time in the MIPO group was shorter than that in the open reduction group[(20.1±8.5 vs.23.9±11.0)d,P<0.05].Compared with the open reduction group,the incidence of postoperative complications in the MIPO group was reduced(P<0.05).Conclusion:VATS assisted MIPO internal fixation surgery for traumatic RF can improve clinical efficacy,with relatively minimal trauma,mild pain and faster postoperative recovery.

关 键 词：胸腔镜 肋骨骨折 微创钢板内固定术 内固定 临床疗效 

分 类 号：R320[医药卫生—人体解剖和组织胚胎学]