陕西医学杂志
陝西醫學雜誌
협서의학잡지
Shaanxi Medical Journal
2015年
10期
1328-1330
,共3页
肋骨%骨折%肿瘤%外科手术,最小侵入性
肋骨%骨摺%腫瘤%外科手術,最小侵入性
륵골%골절%종류%외과수술,최소침입성
Ribs%Fractures%Neoplasms%Surgical procedures,minimally invasive
目的：探讨多小切口肋骨手术在肋骨良性肿瘤或瘤样病变切除术和肋骨骨折肋骨纯钛接骨板内固定术中的优缺点。方法：术前在体表贴铅字精确定位肋骨切除点和肋骨骨折处，并各定位点处设计2～3cm小切口，钝性分离病变，然后切除肋骨肿瘤或瘤样病变、用肋骨接骨板内固定骨折肋骨。结果：31例患者手术经过顺利，肋骨良性肿瘤及瘤样病变切除彻底；骨折患者术后胸壁稳定性明显改善，2例吸烟25年以上的患者分别出现轻度肺不张，支气管镜下吸痰后，肺不张消失，其余患者无传统手术常见并发症。结论：对于部分细长型的肋骨良性肿瘤或瘤样病变采用双小切口切除病变肋骨，安全可靠；对于闭合性的多根多处肋骨骨折采用多小切口肋骨接板内固定术，远期生活质量优于普通单切口手术。对年轻女性患者更有推广价值。
目的：探討多小切口肋骨手術在肋骨良性腫瘤或瘤樣病變切除術和肋骨骨摺肋骨純鈦接骨闆內固定術中的優缺點。方法：術前在體錶貼鉛字精確定位肋骨切除點和肋骨骨摺處，併各定位點處設計2～3cm小切口，鈍性分離病變，然後切除肋骨腫瘤或瘤樣病變、用肋骨接骨闆內固定骨摺肋骨。結果：31例患者手術經過順利，肋骨良性腫瘤及瘤樣病變切除徹底；骨摺患者術後胸壁穩定性明顯改善，2例吸煙25年以上的患者分彆齣現輕度肺不張，支氣管鏡下吸痰後，肺不張消失，其餘患者無傳統手術常見併髮癥。結論：對于部分細長型的肋骨良性腫瘤或瘤樣病變採用雙小切口切除病變肋骨，安全可靠；對于閉閤性的多根多處肋骨骨摺採用多小切口肋骨接闆內固定術，遠期生活質量優于普通單切口手術。對年輕女性患者更有推廣價值。
목적：탐토다소절구륵골수술재륵골량성종류혹류양병변절제술화륵골골절륵골순태접골판내고정술중적우결점。방법：술전재체표첩연자정학정위륵골절제점화륵골골절처，병각정위점처설계2～3cm소절구，둔성분리병변，연후절제륵골종류혹류양병변、용륵골접골판내고정골절륵골。결과：31례환자수술경과순리，륵골량성종류급류양병변절제철저；골절환자술후흉벽은정성명현개선，2례흡연25년이상적환자분별출현경도폐불장，지기관경하흡담후，폐불장소실，기여환자무전통수술상견병발증。결론：대우부분세장형적륵골량성종류혹류양병변채용쌍소절구절제병변륵골，안전가고；대우폐합성적다근다처륵골골절채용다소절구륵골접판내고정술，원기생활질량우우보통단절구수술。대년경녀성환자경유추엄개치。
Objective:Analysis experience of rib operation by more small incisions in 31 cases ,and investi‐gate the advantages and disadvantages of rib operation by more small incisions in excision of rib benign tumor or tumor‐like lesion and internal fixation of rib fractures with titanium rib‐plate .Methods:Paste type on the lesion area for the preoperative accurate positioning rib resection points and rib fractures ,and design 2‐3cm small incisions re‐spectively through every location point ,and then complete blunt separation ,resection of rib tumors or tumor‐like le‐sions and internal fixation of rib fracture with rib‐plate .Results :All operations were smoothly in 31 cases .Rib be‐nign tumor and tumor‐like lesions were removed completely ;and stability of chest wall were significantly improved in patients with rib fractures .Mild pulmonary atelectasis disappeared after bronchoscopic sputum suction in 2 patients more than 25 years of smoking .There were no complications of traditional operation in the remaining patients .Con‐clusion :Excision of rib lesions are safe and reliable for some of slender rib benign tumors or tumor‐like lesions by double small incisions ;and the patients of closed multiple rib fractures accepting internal fixation of rib fractures with rib‐plate by more small incisions had better long‐term quality of life than by ordinary single incision operation .There are more promotional value for young female patients .
