摘要
目的分析对多发肋骨骨折患者采用镍钛合金肋骨环抱器结合电视辅助胸腔镜下可吸收线肋骨捆扎牵引技术治疗的临床优势。方法选取本院2017年10月至2019年10月期间收治的多发肋骨骨折患者148例作为研究对象,按照就诊时间分成两组,各74例。观察组采用环抱器接骨结合胸腔镜治疗,对照组采用常规环抱器接骨治疗。统计两组患者临床治疗效果以及感染等不良反应的发生情况;对比两组患者手术时间、胸痹缓解时间、下床活动时间、拔除引流管时间、手术出血量、胸管引流量等临床各项指标;对比两组患者术前术后VAS疼痛评分以及PaO2(动脉血氧分压)、PaCO2(动脉血二氧化碳分压)水平变化。结果观察组治疗效果为93.24%,高于对照组74.32%,不良反应发生率为2.70%,低于对照组9.46%,差异均有统计学意义(均P<0.05);观察组手术时间、胸痹缓解时间、下床活动时间、拔除引流管时间、手术出血量、胸管引流量分别为(56.71±5.35)min、(4.31±1.06)d、(7.84±2.46)d、(3.02±0.84)d、(83.28±11.22)ml、(321.76±53.65)ml,均优于对照组(85.13±7.39)min、(11.44±4.53)d、(15.75±4.68)d、(5.48±1.22)d、(174.56±19.28)ml、(563.48±94.37)ml,差异均有统计学意义(均P<0.05);术前,两组患者疼痛评分比较,差异无统计学意义(P>0.05);术后1 d、3 d,观察组疼痛评分分别为(7.11±0.32)分、(3.47±0.29)分,均低于对照组(8.45±0.33)分、(5.88±0.36)分,差异均有统计学意义(均P<0.05);术前,两组患者血气指标比较,差异均无统计学意义(均P>0.05);术后,观察组PaO2、PaCO2指标分别为(105.32±2.75)mmHg(1 mmHg=0.133 kPa)、(28.92±1.12)mmHg,均优于对照组(80.21±3.14)mmHg、(43.56±1.55)mmHg,差异均有统计学意义(均P<0.05)。结论对多发肋骨骨折采用镍钛合金肋骨环抱器结合电视辅助胸腔镜下可吸收线肋骨捆扎牵引技术治疗能够有效改善患者各项临床指标,提高治疗有效率,降低不良反应发生率,利于患者预后恢复。
Objective To analyze the clinical advantages treating patients with multiple rib fractures by nickel-titanium rib embracing device combined with absorbable wire rib strapping traction technique under video-assisted thoracoscope for multiple rib fractures.Methods A total of 148 patients with multiple rib fractures treated in our hospital from October,2017 to October,2019 were selected as research objects.They were divided into an experimental group,treated with nickel-titanium rib embracing device and absorbable wire rib strapping traction technique under video-assisted thoracoscope,and a control group,conventionally treated with embracing osteosynthesis,according to the consultation time,with 74 cases in each group.The clinical efficacies,incidence of adverse reactions such as infection,operation times,remission times of chest palliation,times for off-bed activity,times to remove drainage tube,surgical bleeding volumes,and chest drainage volumes were compared between the two groups.The VAS scores,arterial blood oxygen pressure(PaO2),and arterial blood carbon dioxide pressure(PaCO2)before and after the operation were compared between these two groups.Results The treatment efficacy was higher and the incidence of adverse reactions was lower in the experimental group than in the control group(93.24%vs.74.32%and 2.70%vs.9.46%;both P<0.05).The operation time,remission time of chest palliation,time for off-bed activity,time to remove drainage tube,surgical bleeding volume,and chest drainage volume were better in the experimental group than in the control group[(56.71±5.35)min vs.(85.13±7.39)min,(4.31±1.06)d vs.(11.44±4.53)d,(7.84±2.46)d vs.(15.75±4.68)d,(3.02±0.84)d vs.(5.48±1.22)d,(83.28±11.22)ml vs.(174.56±19.28)ml,and(321.76±53.65)ml vs.(563.48±94.37)ml;all P<0.05].There was no statistical difference in VAS score between these group before the operation(P>0.05).1 and 3 days after the operation,the VAS scores were lower in the experimental group than in the control group[(7.11±0.32)vs.(8.45±0.33)and(3.47±0.29)vs.(5.88±0.36);both P<0.05].There were statistical differences in the PaO2 and PaCO2 between these group before the operation(both P>0.05).After the operation,the PaO2 and PaCO2 were better in the in the experimental group than in the control group[(105.32±2.75)mmHg(1 mmHg=0.133 kPa)vs.(80.21±3.14)mmHg and(28.92±1.12)mmHg vs.(43.56±1.55)mmHg;both P<0.05].Conclusions Nickel-titanium rib embracing device combined with absorbable wire rib strapping traction technique under videoassisted thoracoscope for patients with multiple rib fractures can effectively improve their clinical indicators and the treatment efficacy,reduce the incidence of adverse reactions,and help them recover.
作者
杨磊
陈晓军
于健
刘超
宋杨杨
张金贵
Yang Lei;Chen Xiaojun;Yu Jian;Liu Chao;Song Yangyang;Zhang Jingui(Department of Chest Surgery,Hospital Affiliated to Binzhou Medical University(Binzhou Central Hospital),Binzhou 251700,China)
出处
《国际医药卫生导报》
2020年第14期2067-2071,共5页
International Medicine and Health Guidance News
关键词
多发肋骨骨折
镍钛合金肋骨环抱器
胸腔镜
肋骨捆扎牵引技术
Multiple rib fractures
Nickel-titanium rib embracing device
Thoracoscopy
Rib strapping traction technique
