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
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
傅景梁 1杜祥昆 1何荣琦1
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作者信息
1. 福建省泉州市第一医院胸外科,福建泉州 362000
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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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