胸腔镜下肋骨骨折内固定术的临床效果分析

目的 对比观察不同胸腔镜下肋骨骨折内固定术式的临床效果.方法 选取2012年2月～2013年5月鹤壁市人民医院收治的多处肋骨骨折患者50例,按数字法随机分为对照组与观察组各25例,在腹腔镜辅助下,观察组应用镍钛记忆合金环抱式接骨板手术治疗,对照组采用合成树脂人工骨肋骨钉进行内固定,比较2组的临床效果.结果 观察组的总体治疗优良率与对照组相比差异无统计学意义（P〉0.05）,观察组手术时间长于对照组,差异有统计学意义（P〈0.05）;2组患者在住院时间上差异无统计学意义（P〉0.05）,术后疼痛程度上对照组要优于观察组,观察组骨折愈合时间长于对照组,且观察组的术后并发症发生率明显高于对照组的发生率,组间差异均具有统计学意义（P＜0.05）.结论 腹腔镜辅助下,采用镍钛记忆合金环抱器及合成树脂人工骨肋骨钉两种内固定术治疗肋骨骨折各有优缺点,可根据临床实际情况及患者承受能力进行选择.

Analysis on Clinical Effect of Internal Fixation of Rib Fracture under Thoracoscopy

Objective Compare and observe the clinical effect of internal fixation of rib fracture un-der different thoracoscopies. Methods 50 cases of patients with multiple rib fractures in the author＇ s institution between February 2012 and Mai 2013 are selected. 25 cases are respectively assigned to a comparison group and an observation group by using random number table method. Assisted with laparo-scope, diagnosis of locking plate by Ni-Ti memory alloy embracing fixator is applied in the operation of the observation group. Internal fixation by artificial synthetic resin bone with rib-connecting-pins is ap- plied to the comparison group. The clinical effects of the two groups are compared. Results The overall excellent rate of the observation group has no statistical significance compared to the result of the compari-son group （P 〉 0.05）. Observation group lasts longer than comparison group and the difference has sta-tistical significance （P 〈 0.05）. The hospitalization periods of the two groups have no statistical signifi-cance （P 〉 0.05）. With respect to the pain degree after operation the comparison group is better than observation group. The fracture healing time of the observation group is longer than that of comparison group and the incidence rate of complications after operation of the observation group is apparently higher than that of the comparison group. The difference between groups has statistical significance （P 〈 0.05 ）. Conclusion With the assistance of thoracoscopy, the two internal fixation methods on diagnosis of rid fracture, respectively by Ni-Ti memory alloy embracing fixator and artificial synthetic resin bone with rib-connecting-pins, both have their advantages and disadvantages. Choices can be made according to clini-cal practices and financial capabilities of the patients.