胸腔镜辅助经胸内固定与传统开胸手术对多发肋骨骨折患者近远期的疗效比较
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福建省自然科学基金(2023J011780);


Comparison of short-term and long-term curative effects of thoracoscopic-assisted transthoracic internal fixation and traditional thoracotomy on pa-tients with multiple rib fractures
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    摘要:

    目的:比较胸腔镜辅助(VATS)经胸内固定与传统开胸手术对多发肋骨骨折患者近远期疗效。方法:对106例多发肋骨骨折患者资料进行回顾性分析,依据手术方式的不同分为传统组(传统开胸手术)和VATS组(VATS经胸内固定术),应用倾向性评分匹配法(卡钳值0.01,1∶1)匹配两组,最终每组各53例。比较两组患者围手术期指标、并发症发生率,术后疼痛程度(VAS)、病情恢复情况、远期疗效。结果:VATS组手术时间、总住院时间等均短于传统组(P<0.05),并发症发生率低于传统组(P<0.05);术后5 d及7 d,两组VAS评分均随时间延长而下降(P<0.05),且VATS组术后1、5、7 d VAS评分均低于传统组(P<0.05);VATS组骨折对位率、切口愈合率、术后效果优良率均高于传统组(P<0.05)。结论:与传统开胸手术相比,VATS经胸内固定手术可准确定位,缩短手术时间,能促进多发肋骨骨折术后恢复,术后并发症较少,远期疗效理想,值得推广应用。

    Abstract:

    Objective:To compare the short-term and long-term curative effects of video-assisted thoracoscopic surgery(VATS)transthoracic internal fixation and traditional thoracotomy on patients with multiple rib fractures.Methods:The data of 106 patients with multiple rib fractures were retrospectively analyzed.The patients were classified into two groups by using to the different surgical meth-ods,including traditional group(traditional thoracotomy)and VATS group(VATS transthoracic internal fixation).The propensity score matching method(caliper=0.01,at a ratio of 1:1)was used to match the two groups.53 cases were finally obtained in each group.The perioperative indicators,incidence rates of complications,postoperative pain degree(VAS),disease recovery status and long-term curative effect were compared between groups.Results:The VATS group had shorter surgical time and total hospitalization time(P<0.05),and the incidence rates of complications were lower(P<0.05).At 5 and 7 days after surgery,the VAS score was de-creased with time(P<0.05),and the VAS score in VATS group at 1,5,and 7 days after surgery was lower(P<0.05).The fracture alignment rate,incision healing rate and excellent and good rate of postoperative effect were higher in VATS group(P<0.05).Conclu-sion:Compared with traditional thoracotomy,VATS transthoracic internal fixation can more accurately locate the fracture,shorten the surgical time,promote the postoperative recovery of multiple rib fractures,with few postoperative complications and ideal long-term cura-tive effect,which is worthy of clinical application.

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傅景梁;杜祥昆;何荣琦;.胸腔镜辅助经胸内固定与传统开胸手术对多发肋骨骨折患者近远期的疗效比较[J].川北医学院学报,2025,40(1):37-40.

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  • 在线发布日期: 2025-07-24
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