电视胸腔镜辅助肋骨内固定术治疗多发肋骨骨折的效果

目的探讨电视胸腔镜辅助肋骨内固定术治疗多发肋骨骨折的效果。方法将60例多发肋骨骨折患者随机分为胸腔镜组(n=30,电视胸腔镜辅助肋骨内固定术)与开胸组(n=30,传统开胸手术)。比较两组治疗效果。结果术后2个月,胸腔镜组的MVV、FEV1/FVC、FVC均高于开胸组(P<0.05)。术后1 d,两组的SaO2、PaO2/FiO2均较术前升高,且胸腔镜组高于开胸组(P<0.05)。术后3 d,胸腔镜组VAS评分低于开胸组(P<0.05)。胸腔镜组并发症总发生率低于开胸组,骨折愈合率高于开胸组(P<0.05)。结论胸腔镜辅助肋骨内固定术可明显改善多发肋骨骨折患者的肺通气功能及血气指标,术后疼痛程度较轻,并发症较少,骨折愈合率高。

Effect of video-assisted thoracoscopic rib internal fixation on multiple rib fractures

Objective To explore the effect of video-assisted thoracoscopic rib internal fixation on multiple rib fractures. Methods Sixty patients with multiple rib fractures were randomly divided into thoracoscopic group(n =30,video-assisted thoracoscopic rib internal fixation) and thoracotomy group(n=30, traditional thoracotomy). The therapeutic effects of the two groups were compared. Results At two months after operation, the MVV, FEV1/FVC and FVC in the thoracoscopic group were higher than those in the thoracotomy group(P <0.05). At one day after operation, SaO2 and PaO2/FiO2 in the two groups were higher than those before operation, and those in the thoracoscopic group were higher than the thoracotomy group(P <0.05). On the third day after operation, the VAS score in the thoracoscopic group was lower than that in the thoracotomy group(P<0.05). The total incidence of complications in the thoracoscopic group was lower than that in the thoracotomy group, and the fracture healing rate was higher than that in the thoracotomy group( P<0.05). Conclusion Video-assisted thoracoscopic rib internal fixation can significantly improve the pulmonary ventilation function and blood gas indexes of patients with multiple rib fractures, with less postoperative pain and high fracture healing rate.