重庆医学2016，Vol.45Issue(19)：2614-2616,2619,4.DOI:10.3969/j.issn.1671-8348.2016.19.007
胸腔镜手术与传统剖胸手术对多发肋骨骨折合并肺撕裂伤的急诊手术治疗比较分析
Comparative analysis on thoracoscopic surgery and conventional thoracotomy for emergency surgical treatment in multiple rib fracture complicating pulmonary laceration
摘要
Abstract
Objective To compare the effect of video‐assisted thoracoscopic(VAT) surgery and conventional thoracotomy in emergency treatment of multiple rib fracture complicating pulmonary laceration to provide the reference for clinical treatment .Meth‐ods Forty‐seven cases of multiple rib fracture complicating pulmonary laceration in our hospital from April 2013 to April 2014 were selected and divided into the VAT group(n=32) and thoracotomy group(n=15) according to the willingness of patients .The two groups performed the thoracoscopic and traditional thoracotomy titanium nickel alloy rib plate treatment respectively .The sur‐gery situation ,complications and changes of perioperative blood gas levels were compared between the two groups .Results The op‐eration time ,intraoperative bleeding volume ,ICU hospitalization time ,total hospitalization time and postoperative analgesic in the VAT group were lower than those in the thoracotomy group ,the differences were statistically significant (P<0 .05);the VAS score on postoperative 1 d had statistical difference(P<0 .01) .Compared with before operation ,arterial PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the two groups were increased ,while PaCO2 was decreased ,and the differences were statistically significant (P<0 .05);PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the VAT group were higher than those in the thoracotomy group , while PaCO2 was lower than that in the thoracotomy group ,and the differences were statistically significant (P<0 .05) .The occur‐rence rate of complications had no statistical difference between the VAT group and thoracotomy group (3 .1% vs .6 .7% ,P>0 .05) .The excellent rate in the VAT group was 90 .6% ,which was higher than 66 .7% in the thoracotomy group ,and the differ‐ence was statistically significant (P<0 .05) .Conclusion Thoracoscopic internal fixation for the treatment of multiple rib fractures complicating laceration has the advantages of minimal trauma ,convenient operation and high safety ,could effectively alleviate the patient′s sufferring ,improve the living quality ,and be a better way of treatment .关键词
多发肋骨骨折/肺撕裂伤/急诊手术/胸腔镜/传统剖胸手术Key words
multiple rib fractures/pulmonary laceration/emergency operation/thoracoscopy/conventional thoracic operation分类
医药卫生引用本文复制引用
苟亚军,尹昌林,陈翔宇,李燕,田铸,刘明华..胸腔镜手术与传统剖胸手术对多发肋骨骨折合并肺撕裂伤的急诊手术治疗比较分析[J].重庆医学,2016,45(19):2614-2616,2619,4.基金项目
国家卫生行业专项（201302016）。 （）
