局麻下小切口微创锁骨内固定装置去除术与传统去除术的临床疗效比较  

Comparison of Clinical Effects Between Minimally Invasive Under Local Anesthesia and Traditional Technology in Clavicular Internal Fixation Devices Removal

作　　者：陈辉璜 林佳俊[1] 陈敏[1] 何龙鹏 刘文革[1] CHEN Huihuang;LIN Jiajun;CHEN Min;HE Longpeng;LIU Wen′ge(Department of Orthopaedics,Fujian Medical University Union Hospital,Fuzhou Fujian 350001,China;Department of Orthopaedics,Pingtan Comprehensive Experimental Area Hospital,Pingtan Fujian 350400,China)

机构地区：[1]福建医科大学附属协和医院骨科,福建福州350001 [2]平潭综合实验区医院骨科,福建平潭350400

出　　处：《中国卫生标准管理》2023年第23期90-93,共4页China Health Standard Management

摘　　要：目的比较局麻下小切口微创锁骨内固定装置去除术与传统锁骨内固定装置去除术的临床疗效。方法选取2018年9月—2022年8月福建医科大学附属协和医院收治的68例行锁骨内固定装置去除术患者。根据所行术式不同,分为观察组(n=39)与对照组(n=29)。观察组采用局麻下小切口微创锁骨内固定装置去除术去除锁骨内固定装置,对照组患采用传统锁骨内固定装置去除术。比较两组患者术前汉密尔顿焦虑评分(Hamilton anxiety scale,HAMA)、汉密尔顿抑郁评分(Hamilton depression scale,HAMD)、手术时间、切口长度、出血量、术后第1天疼痛视觉模拟评分(visual analogue scale,VAS)、术后第5天VAS评分、HAMA评分、HAMD评分、术后住院天数及随访期内并发症情况。结果随访期内,观察组手术时间[(31.38±6.33)min]、出血量[(8.79±2.64)mL]较对照组[(53.14±14.61)min、(26.03±11.80)mL]更少(t=8.324、8.852,P<0.001),切口长度[(2.64±0.51)cm]、术后住院时间[(2.10±0.50)d]较对照组[(9.93±1.44)cm、(2.69±1.31)d]更短(t=29.298、2.288,P<0.05)。观察组术后HAMA、HAMD评分、术后VAS评分和并发症发生率优于对照组,差异均有统计学意义(P<0.05)。结论采用局麻下小切口微创锁骨内固定装置去除术,较传统锁骨内固定装置去除术可以减少手术时间、出血量,缩短切口长度及住院时间,降低术后疼痛程度及并发症发生率,也有助于改善精神状态和提高治疗周转效率。Objective To compare the clinical effects of minimally invasive under local anesthesia technology with removal of traditional clavicular internal fixation device in clavicular internal fixation devices removal.Methods From September 2018 to August 2022,a total of 68 patients who underwent clavicular internal fixation device removal surgeries in Fujian Medical University Union Hospital were selected.According to the difference of surgical procedures,the patients were divided into the observation group(n=39)and the control group(n=29).The observation group patients were treated with minimally invasive under local anesthesia technology,while the control group patients were treated with removal of traditional clavicular internal fixation device.The preoperative Hamilton anxiety scale(HAMA)and Hamilton depression scale(HAMD),the operation time,incision length,bleeding volume,visual analogue scale(VAS)on 1 d after operation,VAS,HAMA and HAMD on day 5 d operation,postoperative hospital stay and complications between the patients of two groups were compared.Results During the follow-up period,the operation time and bleeding volume of the observation group[(31.38±6.33)min and(8.79±2.64)mL]were lower than those of the control group[(53.14±14.61)min and(26.03±11.80)mL](t=8.324,8.852,P<0.001).The incision length and postoperative hospital stay of the observation group[(2.64±0.51)cm and(2.10±0.50)d]were shorter compared with those of the control group[(9.93±1.44)cm and(2.69±1.31)d](t=29.298,2.288,P<0.05).The observation group also had the advantages of lower anxiety,depression scale,VAS and incidence of complications compared to the control group,with significant difference(P<0.05).Conclusion Comparing to traditional technology,the application of minimally invasive under local anesthesia technology for the removal of clavicular internal fixation devices can reduce the operation time,bleeding volume,incision length,postoperative hospital stay,pain and complications.It also helps to improve the mental state and increase

关 键 词：锁骨 内固定去除术 微创 切口长度 精神状态 临床疗效 

分 类 号：R683[医药卫生—骨科学]