摘要
目的探讨胸腔镜辅助结合术中针头精确定位小切口重点固定法治疗多发肋骨骨折的临床效果。方法回顾性分析2010年1月～2014年6月我科行记忆合金环抱器内固定术治疗多发肋骨骨折88例患者的临床资料,按手术方法分为两组：研究组46例,采用胸腔镜辅助结合术中针头精确定位小切口重点固定法;对照组42例,采用大/多切口、逐一固定法;比较两组患者的临床疗效。结果两组患者均顺利出院。所有病例均获随访,随访时间平均5（3～10）个月,均无胸廓畸形及环抱器移位、脱落及感染。研究组切口长度及数量、胸痛强度、胸痛时间、置管时间、住院时间、环抱器植入数量、肺部并发症（肺部感染、肺不张、包裹性胸腔积液）以及医疗费用等均明显少于对照组,差异具有统计学意义（P〈0.05）。结论胸腔镜辅助结合术中针头精确定位小切口重点固定法治疗多发肋骨骨折的临床疗效明显优于大/多切口、逐一固定法,具有微创、并发症少、恢复快、异物植入少、费用低、易于掌握等优点,值得临床推广。
Objective To explore the clinical value of the internal fixation of the key parts of the multiple rib fractures with mini-incision located accurately by thoracoscopy combined with needle puncture. Methods The clinical data of 88 multiple rib fractures cases performed internal fixation with alloy embracing holder from January 2010 to June 2014 were analyzed retrospectively. According to surgical procedure,they were divided into the research group（ n = 46） and control group（ n = 42）. The former was treated by internal fixation of the key parts of the multiple ribs fractures with small incision located accurately by thoracoscopy combined with needle puncture,and the latter was performed internal fracture fixation of multiple ribs fractures with large/ multi incisions. The clinical effect was compared between two groups. Results All cases were followed up for 3 to 10 months with an average of 5 months. No thoracocyllosis,displacement or defluxion of embracing holder and infection was found. The length and the numbers of incision,intensity and duration of chest pain,drainage duration,hospital stays,the numbers of the implanted embracing holder,pulmonary complications（ as pulmonary infection,pulmonary atelectasis,encapsulated pleural effusion）,and medical cost in the research group were significantly less than those in the control group,and there was statistical difference between two groups（ P 〈0. 05）.Conclusion The internal fixation of the key parts of multiple rib fractures with small incision located accurately by thoracoscopy combined with needle puncture has the advantages of minimal invasive,fewer complications,faster recovery,less implanted foreign body and low cost,and it deserves to be popularized.
出处
《中国现代手术学杂志》
2015年第2期133-136,共4页
Chinese Journal of Modern Operative Surgery
关键词
肋骨骨折
骨折固定术
内
胸腔镜检查
切口
手术后并发症
rib fractures fracture fixation internal thoracoscopy incision postoperative complications
