中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Trauma
2015年
11期
991-994
,共4页
茅一民%周振宇%叶芃%吕望%胡坚
茅一民%週振宇%葉芃%呂望%鬍堅
모일민%주진우%협봉%려망%호견
骨折固定术,内%肋骨骨折%胸腔镜
骨摺固定術,內%肋骨骨摺%胸腔鏡
골절고정술,내%륵골골절%흉강경
Fracture fixation,internal%Rib fractures%Thoracoscopes
目的 探讨内固定术联合应用胸腔镜治疗肋骨骨折的疗效. 方法 选择2010年7月-2013年6月收治的180例肋骨骨折伴胸廓畸形患者,根据治疗方法不同分为内固定术联合胸腔镜组(手术组,90例)和非手术治疗组(非手术组,90例).观察两组疼痛持续时间、呼吸机使用时间、住院时间、并发症等临床指标;通过自尊量表评分(SES)评价两组患者心理健康状况;并比较两组患者活动能力受限情况. 结果 手术组疼痛持续时间为(3.1±1.0)d,呼吸机使用时间为(3.0±1.0)d,住院时间为(10.0±1.1)d,非手术组分别为(8.9±1.2)d、(4.8±1.0)d、(15.8±1.0)d(P均＜0.01).手术组、非手术组SES分别为(28.3±2.1)分、(24.4±3.3)分(P＜0.01).手术组未见明显并发症,2例术后活动能力受限.非手术组41例出现严重并发症(20例胸腔积液,15例严重胸廓塌陷、畸形,14例肺部感染,10例顽固性胸痛,2例上肢功能受伤),12例出现活动明显受限.两组在并发症发生率及活动能力受限方面差异均有统计学意义(P＜0.01). 结论 内固定联合胸腔镜治疗肋骨骨折能够加快康复速度,减轻疼痛及降低并发症发生率,是可优先选择的手术模式.
目的 探討內固定術聯閤應用胸腔鏡治療肋骨骨摺的療效. 方法 選擇2010年7月-2013年6月收治的180例肋骨骨摺伴胸廓畸形患者,根據治療方法不同分為內固定術聯閤胸腔鏡組(手術組,90例)和非手術治療組(非手術組,90例).觀察兩組疼痛持續時間、呼吸機使用時間、住院時間、併髮癥等臨床指標;通過自尊量錶評分(SES)評價兩組患者心理健康狀況;併比較兩組患者活動能力受限情況. 結果 手術組疼痛持續時間為(3.1±1.0)d,呼吸機使用時間為(3.0±1.0)d,住院時間為(10.0±1.1)d,非手術組分彆為(8.9±1.2)d、(4.8±1.0)d、(15.8±1.0)d(P均＜0.01).手術組、非手術組SES分彆為(28.3±2.1)分、(24.4±3.3)分(P＜0.01).手術組未見明顯併髮癥,2例術後活動能力受限.非手術組41例齣現嚴重併髮癥(20例胸腔積液,15例嚴重胸廓塌陷、畸形,14例肺部感染,10例頑固性胸痛,2例上肢功能受傷),12例齣現活動明顯受限.兩組在併髮癥髮生率及活動能力受限方麵差異均有統計學意義(P＜0.01). 結論 內固定聯閤胸腔鏡治療肋骨骨摺能夠加快康複速度,減輕疼痛及降低併髮癥髮生率,是可優先選擇的手術模式.
목적 탐토내고정술연합응용흉강경치료륵골골절적료효. 방법 선택2010년7월-2013년6월수치적180례륵골골절반흉곽기형환자,근거치료방법불동분위내고정술연합흉강경조(수술조,90례)화비수술치료조(비수술조,90례).관찰량조동통지속시간、호흡궤사용시간、주원시간、병발증등림상지표;통과자존량표평분(SES)평개량조환자심리건강상황;병비교량조환자활동능력수한정황. 결과 수술조동통지속시간위(3.1±1.0)d,호흡궤사용시간위(3.0±1.0)d,주원시간위(10.0±1.1)d,비수술조분별위(8.9±1.2)d、(4.8±1.0)d、(15.8±1.0)d(P균＜0.01).수술조、비수술조SES분별위(28.3±2.1)분、(24.4±3.3)분(P＜0.01).수술조미견명현병발증,2례술후활동능력수한.비수술조41례출현엄중병발증(20례흉강적액,15례엄중흉곽탑함、기형,14례폐부감염,10례완고성흉통,2례상지공능수상),12례출현활동명현수한.량조재병발증발생솔급활동능력수한방면차이균유통계학의의(P＜0.01). 결론 내고정연합흉강경치료륵골골절능구가쾌강복속도,감경동통급강저병발증발생솔,시가우선선택적수술모식.
Objective To discuss the clinical efficacy of internal fixation assisted by thoracoscope in treatment of rib fractures.Methods The study enrolled 180 patients with rib fractures associated with thoracic deformity hospitalized from July 2010 to June 2013.Ninety out of the patients were operated on by thoracoscope-assisted internal fixation (operation group),and the remaining 90 fractures were treated non-operatively (non-operation group).Clinical markers recorded were duration of pain,time of ventilator use,hospital length of stay and complications.Patient mental health was measured with self esteem scale (SES).Patient mobility was evaluated at follow-up.Results Between operation and non-operation groups differences were observed in duration of pain [(3.1 ± 1.0)d vs (8.9 ± 1.2) d],time of ventilator use [(3.0 ± 1.0) d vs (4.8 ± 1.0) d] and hospital length of stay [(10.0 ± 1.1) d vs (15.8 ± 1.0) d] (P ＜ 0.01).SES in operation group was (28.3 ± 2.1) versus (24.4 ± 3.3) points in non-operation group (P ＜ 0.01).No major complications occurred in operation group,but there were 20 pleural effusion,15 severe thoracic collapse or deformity,14 lung infection,10 refractory chest pain and 2 upper limb dysfunction in non-operation group (P ＜0.01).Two patients presented mobility limitation in operation group,but 12 had evident loss of mobility in non-operation group (P ＜0.01).Conclusions Thoracoscope-assisted internal fixation is effective to accelerate the pace of recovery,relieve pains,reduce complications and thus can be a priority method for treatment of rib fractures.
