目的 探讨胸腔镜辅助下内固定术治疗多发肋骨骨折的临床疗效及对快速康复的影响。方法 回顾性分析2020-01至2024-12海警医院收治的120例多发肋骨骨折患者的临床资料,按手术方法不同,分为胸腔镜组(n=60)与传统开胸组(n=60),对比手术指标、术后恢复、疼痛评分(VAS)、并发症。结果 胸腔镜组手术时间[(65.2±8.5) min vs. (85.3±10.2)min]、术中出血量[(95.6±30.1) ml vs. (142.7±45.3)ml]及切口长度[(3.2±0.8) cm vs. (16.5±2.1)cm]显著优于传统开胸组,差异有统计学意义(P<0.05);胸腔镜组术后VAS评分、下床活动时间、住院时间及肺功能恢复时间均显著低于或短于传统开胸组,差异有统计学意义(P<0.05);胸腔镜组并发症发生率为6.7%,明显低于传统开胸组的22.3%,差异有统计学意义(P<0.05)。结论 胸腔镜下内固定术创伤小、恢复快,明显改善患者预后,符合快速康复外科理念,值得推广。
Abstract
Objective To explore the clinical efficacy of thoracoscopic-assisted internal fixation for multiple rib fractures and its influence on enhanced recovery. Methods The clinical data of 120 patients with multiple rib fractures admitted to Coast Guard Hospital of Chinese People’s Armed Police Force from January 2020 to December 2024 were retrospectively analyzed. According to different surgical methods, the patients were divided into a thoracoscopic group (n=60) and a traditional thoracotomy group (n=60). The surgical indicators, postoperative recovery, pain score (VAS), complications, and quality of life (SF-36 score) were compared between the two groups. Results The thoracoscopic group showed significantly better outcomes in operation time[(65.2±8.5) min vs. (85.3±10.2 )min], intraoperative blood loss[(95.6±30.1) ml vs. (142.7±45.3 )ml], and incision length[(3.2±0.8 )cm vs. (16.5±2.1 )cm], with statistically significant differences (P<0.05).The postoperative VAS scores, time to ambulation, hospital stay, and recovery time of lung function of the thoracoscopic group were significantly lower or shorter than those of the traditional thoracotomy group, with statistically significant differences (P<0.05). The complication rate of the thoracoscopic group was 6.7%, significantly lower than 22.3% of the traditional thoracotomy group, with statistically significant difference (P<0.05). Conclusions Thoracoscopic-assisted internal fixation surgery is minimally invasive, promotes fast recovery, and significantly improves the prognosis of patients, which conforms to the enhanced recovery concept and is worthy of promotion.
关键词
多发肋骨骨折 /
内固定术 /
胸腔镜 /
快速康复理念 /
微创手术
Key words
multiple rib fractures /
internal fixation /
thoracoscopy /
enhanced recovery concept /
minimally invasive surgery
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