Department of Thoracic Surgery, Shanghai Pudong Hospital Fudan University Pudong Medical Center, Shanghai 201399, China.
Contrast Media Mol Imaging. 2022 May 18;2022:2079098. doi: 10.1155/2022/2079098. eCollection 2022.
A case-control study was conducted, to assess the complications, short-term effectiveness, and quality of life of video-assisted thoracoscopic surgery with conventional surgery in the treatment of rib fractures.
From February 2018 to April 2021, 100 patients with rib fractures who required surgical treatment at the hospital were selected. Patients were randomly divided into control and study groups. The study group received thoracoscopy-assisted rib internal fixation, and the control group received traditional open reduction and internal fixation for rib fractures. The treatment effect, postoperative complication rate, surgery-related indicators, stress response, blood gas indicators, VAS (visual analog scale) pain score, and SF-36 quality of life score were compared between the two groups.
The total effective rate of the study group was higher than that of the control group, and the difference was statistically significant ( < 0.05). The postoperative complications in the study group were significantly lower than those in the control group ( -5.317; < 0.05), but there was no significant difference in hospitalization costs between the two groups ( > 0.05). The operation time, intraoperative blood loss, incision length, drainage tube placement time, postoperative activity time, and hospital stay in the study group were significantly lower than those in the control group. The SF-36 score and VAS score in the study group were higher than those in the control group ( < 0.05). Compared with the two groups after the operation, the levels of PaO2, SaO2, and PaO2/FiO2 in the study group were significantly higher than those in the control group ( < 0.05). Before surgery, there was no significant difference in stress response indicators such as cortisol, blood sugar, and C-reactive protein between the two groups ( > 0.05), but there was no significant difference in stress response indicators after surgery ( > 0.05). Cortisol, blood sugar, C-reactive protein, and other indicators were increased in both groups, but compared with the control group, the study group had decreased postoperative cortisol, blood sugar, C-reactive protein, and other stress response indicators ( < 0.05).
There is a significant difference between thoracoscopic surgery and traditional surgery in the treatment of rib fractures. The probability of postoperative complications of thoracoscopic surgery is lower, and the operation time, intraoperative blood loss, and incision length are better. The pain of patients before and after the operation is significantly reduced, the quality of life is improved greatly, and the stress response is weak.
采用病例对照研究，评估电视辅助胸腔镜手术与传统手术治疗肋骨骨折的并发症、短期疗效和生活质量。
2018 年 2 月至 2021 年 4 月，我院收治的 100 例需手术治疗的肋骨骨折患者，随机分为对照组和观察组。观察组采用胸腔镜辅助肋骨内固定术，对照组采用传统切开复位内固定术治疗肋骨骨折。比较两组治疗效果、术后并发症发生率、手术相关指标、应激反应、血气指标、视觉模拟评分法（VAS）疼痛评分、SF-36 生活质量评分。
观察组总有效率高于对照组，差异有统计学意义（ < 0.05）。观察组术后并发症发生率明显低于对照组（ -5.317； < 0.05），但两组住院费用比较差异无统计学意义（ > 0.05）。观察组手术时间、术中出血量、切口长度、引流管留置时间、术后活动时间、住院时间均明显短于对照组。观察组 SF-36 评分和 VAS 评分均高于对照组（ < 0.05）。与术后两组比较，观察组 PaO2、SaO2、PaO2/FiO2 水平明显高于对照组（ < 0.05）。术前两组皮质醇、血糖、C 反应蛋白等应激反应指标比较差异无统计学意义（ > 0.05），但术后应激反应指标比较差异无统计学意义（ > 0.05）。两组皮质醇、血糖、C 反应蛋白等指标均升高，但与对照组比较，观察组术后皮质醇、血糖、C 反应蛋白等应激反应指标降低（ < 0.05）。
胸腔镜手术与传统手术治疗肋骨骨折有显著差异。胸腔镜手术的术后并发症发生概率较低，手术时间、术中出血量、切口长度更好。患者术后疼痛明显减轻，生活质量大大提高，应激反应较弱。
