Shi Jinlong, Liu Jing
Jinlong Shi Department of Cardio-Thoracic Surgery, The First People's Hospital of Jingzhou, Jingzhou Hubei 434000, China.
Jing Liu Department of Cardio-Thoracic Surgery, The First Affiliated Hospital of Yangtze University, The Second Hospital of Jingzhou, Jingzhou Hubei 434000, China.
Pak J Med Sci. 2024 Sep;40(8):1632-1637. doi: 10.12669/pjms.40.8.9196.
This study aimed to assess the clinical effect of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in the therapy of multiple rib fractures.
A total of 80 patients with multiple rib fractures in First People's Hospital of Jingzhou from January 2021 to December 2022 were separated into control group (CG, 40 cases) and research group (RG, 40 cases) by random number table method. Patients in the CG received thoracotomy reduction and internal fixation. Patients in the RG received video-assisted thoracoscopic precise positioning reduction and internal fixation. Surgery-related indexes, serum interleukin, visual analogue scale (VAS) was used to evaluate postoperative pain, arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2), and pulmonary function indexes were measured in the two groups.
After surgery, Visual analog scale (VAS) scores at 24 hour after surgery were reduced compared to six hour and 12 hour after surgery (P<0.05). VAS score at 12 hour after surgery was increased relative to 6 h after surgery (P<0.05), and VAS score at six hour, 12 hour as well as 24 hour after surgery in the RG was lessened in comparison with the CG (P<0.05). One day after surgery, SaO and PaO/FiO in two groups were elevated compared to before surgery, and those in RG was increased in contrast to the CG (P<0.05). forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow velocity (PEF) along with FEV1/FVC levels in two groups were increased (P<0.05).
Compared with thoracotomy reduction and internal fixation, video-assisted thoracoscopic accurate positioning and internal fixation in treating patients with multiple rib fractures had a short treatment time, obvious advantages, and strong feasibility.
本研究旨在评估电视胸腔镜精准定位复位内固定术与开胸复位内固定术治疗多发性肋骨骨折的临床效果。
选取2021年1月至2022年12月在荆州市第一人民医院就诊的80例多发性肋骨骨折患者，采用随机数字表法分为对照组（CG，40例）和研究组（RG，40例）。对照组患者接受开胸复位内固定术，研究组患者接受电视胸腔镜精准定位复位内固定术。比较两组手术相关指标、血清白细胞介素、采用视觉模拟评分法（VAS）评估术后疼痛、动脉血氧饱和度（SaO₂）和氧合指数（PaO₂/FiO₂），并测定肺功能指标。
术后，术后24小时的视觉模拟评分（VAS）较术后6小时和12小时降低（P<0.05）。术后12小时的VAS评分较术后6小时升高（P<0.05），且研究组术后6小时、12小时及24小时的VAS评分均低于对照组（P<0.05）。术后1天，两组的SaO₂和PaO₂/FiO₂较术前升高，且研究组高于对照组（P<0.05）。两组的用力呼气量（FEV₁）、用力肺活量（FVC）、呼气峰值流速（PEF）以及FEV₁/FVC水平均升高（P<0.05）。
与开胸复位内固定术相比，电视胸腔镜精准定位内固定术治疗多发性肋骨骨折患者具有治疗时间短、优势明显、可行性强的特点。
