胸腔镜下接骨板治疗多发肋骨骨折预防肺部并发症的效果评价

目的 探讨胸腔镜下接骨板治疗多发肋骨骨折预防肺部并发症的临床效果.方法 选择2007年7月～2011年4月胸外伤患者170例,分为两组,观察组86例采用胸腔镜下接骨板治疗,对照组84例采用常规开放手术治疗,比较两组患者的手术时间、术中出血及术后疼痛VAS评分,并统计术后及随访2个月患者肺部并发症.结果 观察组术中出血显著少于对照组（P＜0.05）,且术后疼痛VAS评分低于对照组（P＜0.05）,观察组术后发生肺不张、肺部感染及低氧血症的比率显著低于对照组（P＜0.05）,出院至随访2个月胸廓畸形、骨折不愈合及肺不张的比率均显著低于对照组（P＜0.05）.结论 胸腔镜辅助肋骨接骨板治疗多发肋骨骨折简单易行,创伤小,切口选择准确,术后肺部并发症少,尤其适用于连枷胸患者.

Effect evaluation of bone plate set under thoracoscopic for rib fracture to prevent pulmonary complications

Objective To evaluate the clinical effect of bone plate set under thoracoscopic for multiple rib fracture to prevent pulmonary complications. Methods 170 patients with rib fracture were chosen from July 2007 to April 2011, were divided into two groups,86 cases of the observation group were used video-assisted thoracoseopic,84 cases of the control group were used conventional open operation,then the operation time,intraoperative bleeding and postoperative pain VAS score of the two groups were compared and the pulmonary complications after operation and follow-up by 2 month were statisticed. Results The intraoperative bleeding of the observation group was less than control group （P〈 0.05）;Postoperative pain VAS score was lower than control group （P〈0.05）;After operation,the pulmonary atelectasis, pulmonary infection and hypoxemia ratio of the observation group were lower than control group （P〈0.05）,2 month after operation,the chest deformity,fracture nonunion and lung ratio atelectasis were lower than control group （P〈0.05）. Conclusion Bone plate set under thoracoscopic is a simple method for rib fracture to prevent pulmonary complications, it has small trauma,incision selected accurate,less postoperative pulmonary complications,so it is refer to patients with flail chest.