快速恢复外科理念在多发性肋骨骨折内固定手术中的应用研究

目的 探讨快速恢复外科(FTS)理念在多发性肋骨骨折内固定手术中的应用研究.方法 对我院2008年3月至2010年3月救治的48例胸外伤合并多发性肋骨骨折患者随机分为FTS组(24例)和传统方法组(24例),分别用FTS和传统围手术期方法处理.比较2组患者术后胸壁疼痛程度及持续时间、早期活动耐量、静脉输液维持时间、相对住院时间、胸壁瘢痕、并发症及其发生率等指标.结果 FTS组术后胸壁疼痛持续时间较传统方法组明显缩短[(112.46±23.24)min与(180.23±51.56)min,t=4.23,P＜0.05];早期活动耐量延长[(68.35±9.30)min与(33.48±5.18)min,t=2.87,P＜0.05];静脉输液维持时间缩短[(10.83±1.87)d与(13.30±2.12)d,t=2.38,P＜0.05];相对住院时间缩短[(12.35±2.03)d与(16.48±3.18)d,t=3.04,P＜0.05];并发症发生率少(8.3%与37.5%,x2=5.005,P＜0.05);术后胸壁疼痛程度减轻[(3.43±0.45)cm与(6.62±0.62)cm,P＜0.05];胸壁瘢痕愈合好.2组患者均顺利康复出院.结论 对于胸外伤合并多发性肋骨骨折的患者,采用FTS的围手术期治疗理念疗效满意,明显提高患者远期生活质量.

Abstract：

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.

Clinical study on fast track surgery in the rib internal fixation of multiple rib fractures

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.