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非插管微创性胸壁稳定治疗多发肋骨骨折:一项前瞻性、单臂研究。

Nonintubated minimally invasive chest wall stabilization for multiple rib fractures: a prospective, single-arm study.

机构信息

Department of Thoracic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.

Department of Anesthesiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.

出版信息

World J Emerg Surg. 2020 Sep 23;15(1):53. doi: 10.1186/s13017-020-00335-y.

Abstract

BACKGROUND

Nonintubated video-assisted thoracoscopic surgery has been widely reported in the past decade, while nonintubated chest wall stabilization has not been reported previously. The aim of this study was to evaluate the safety and feasibility of nonintubated minimally invasive chest wall stabilization in patients with multiple rib fractures.

METHODS

We conducted a prospective, single-arm, observational study. In this prospective study, 20 consecutive patients with multiple rib fractures were treated using nonintubated minimally invasive chest wall stabilization.

RESULTS

Minimally invasive chest wall stabilization was mostly performed for lateral rib fractures in this study (n = 8). The mean operation time was 92.5 min, and the mean blood loss was 49 ml. No patient required conversion to tracheal intubation. The mean extubation time of the laryngeal mask was 8.9 min; the mean postoperative fasting time was 6.1 h; the mean postoperative hospital stay was 6.2 days; the mean amount of postoperative drainage was 97.5 ml; the mean postoperative pain score was 2.9 points at 6 h, 2.8 points at 12 h, and 3.0 points at 24 h; and the mean postoperative nausea and vomiting score was 1.9 points at 6 h, 1.8 points at 12 h, and 1.7 points at 24 h.

CONCLUSIONS

Nonintubated minimally invasive chest wall stabilization is safe and feasible in carefully selected patients. Further studies with a large sample size are warranted.

TRIAL REGISTRATION

ChiCTR1900025698 . Registered on 5 September 2019.

摘要

背景

在过去的十年中,非插管视频辅助胸腔镜手术已经得到了广泛的报道,而非插管胸壁稳定技术尚未见报道。本研究旨在评估非插管微创胸壁稳定技术在多发肋骨骨折患者中的安全性和可行性。

方法

我们进行了一项前瞻性、单臂、观察性研究。在这项前瞻性研究中,20 例多发肋骨骨折患者接受了非插管微创胸壁稳定治疗。

结果

本研究中微创胸壁稳定术主要用于治疗侧方肋骨骨折(n=8)。手术时间平均为 92.5 分钟,出血量平均为 49 毫升。无患者需要转为气管插管。喉罩的平均拔管时间为 8.9 分钟;平均术后禁食时间为 6.1 小时;平均术后住院时间为 6.2 天;平均术后引流量为 97.5 毫升;术后 6 小时、12 小时和 24 小时的平均疼痛评分为 2.9 分;术后 6 小时、12 小时和 24 小时的平均恶心呕吐评分为 1.9 分。

结论

在仔细选择的患者中,非插管微创胸壁稳定术是安全可行的。需要进一步进行样本量更大的研究。

试验注册

ChiCTR1900025698。注册于 2019 年 9 月 5 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07ac/7513522/fb891909d2a1/13017_2020_335_Fig1_HTML.jpg

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