莫军杰 1周君鹏 1骆志航 1施晓青 1陈晓萍 1孙晓1
作者信息
- 1. 杭州市富阳中医骨伤医院 创四病区,浙江 杭州 311400
- 折叠
摘要
Abstract
Objective To explore the clinical efficacy and safety of adjuvant administration of bone trauma therapeutic apparatus after thoracoscopic internal fixation of rib fractures in the treatment of multiple rib fractures(MRF)complicated with hemopneumothorax.Methods 86 patients with MRF combined with hemoppneumothorax from January 2021 to January 2024 were selected.The patients were divided into two groups by random number table method,with 43 cases in each group.Both groups received thoracoscopic internal fixation surgery for rib fractures.The control group was given conventional treatment after the operation,while the observation group was treated with a bone trauma therapeutic apparatus on the basis of the control group.Observe the short-term and long-term therapeutic effects of the two groups of patients.The amount of hemothorax bleeding and the visual analogue scale(VAS)score for pain of the two groups of patients were compared before the operation,3 days after the operation,7 days after the operation and 14 days after the operation.The coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),and D-dimer(D-D)]of the two groups of patients before the operation and 14 days after the operation were compared.Compare the postoperative recovery status(the duration of the drainage tube,the time for swelling to subside,the length of hospital stay and the fracture healing time)and incidence of postoperative complications between two groups of patients.Results The total effective rate of short-term efficacy in the observation group was 97.67%(42/43),which was significantly higher than that in the control group(81.40%,35/43),and the difference was statistically significant(P<0.05).The total effective rate of long-term efficacy in the observation group was 97.67%(42/43),compared with 88.37%(38/43)in the control group,and the difference was not statistically significant(P>0.05).At 3,7 and 14 days after the operation,the amount of hemothorax bleeding in both groups was significantly less than that before the operation,and the amount in the observation group was significantly less than that in the control group.The VAS score for pain was significantly lower than that before the operation in both groups,and the amount in the observation group was significantly lower than that in the control group.The differences were statistically significant(P<0.05).At 14 days after the operation,PT,APTT and TT in both groups were significantly longer than those before the operation in both groups,and the observation group was significantly longer than the control group,FIB and D-D were significantly lower than those before the operation,and the observation group was significantly lower than the control group.The differences were statistically significant(P<0.05).The duration of the drainage tube,the time for swelling to subside,the length of hospital stay and the fracture healing time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 2.33%(1/43),compared with 11.63%(5/43)in the control group,and the difference was not statistically significant(P>0.05).Conclusion After thoracoscopic internal fixation of rib fractures,adjuvant administration of bone trauma therapeutic apparatus can effectively promote the absorption of pleural effusion and pneumothorax in patients with MRF combined with hemopneumothorax,reduce the degree of pain,improve coagulation function,and accelerate postoperative recovery of the body.It is worthy of clinical promotion and application.关键词
骨创伤治疗仪/胸腔镜/骨折固定术/多发肋骨骨折(MRF)/血气胸/微创手术Key words
bone trauma therapeutic apparatus/thoracoscope/fracture fixation/multiple rib fractures(MRF)/hemopneumothorax/minimally invasive surgery分类
医药卫生
